EVALUATION OF THE SPIRAL COMPUTED-TOMOGRA PHY ALONE AND COMBINED WITHCOLOR DOPPLER ULTRASONOGRAPHY IN THE DETECTION OF RENAL-ARTERY STENOSIS - A PROSPECTIVE-STUDY OF 114 RENAL-ARTERIES

A renovascular etiology occurs in 0.2 to 2 % of hypertensive patients. Recently, spiral computed tomography (CT) has evolved as a new minima lly invasive tool for the diagnosis of vascular pathologic conditions. The purpose of this study was to compare both spiral CT and color Dop pler ultrasonography (US) with intraarterial digital subtraction angio graphy (DA) in the detection of renal artery stenosis (RAS) in hyperte nsive patients. Between December 1993 and April 1994, 44 hypertensives (men 22, mean age 52 years) suspected secondary hypertension were pro spectively studied with spiral CT (Somatom Plus S, Siemens) US (Acuson , 3.5 MHz probe) and DA (double-blind evaluation). DA visualized 11 si gnificant (> 50 %) stenoses (11/114 renal arteries, including 27 acces sory). On spiral CT, 9/11 were detected and 2 additional stenoses cons idered false positive. On US 5 stenoses were detected whereas 11 were demonstrated by DA; 2 patients had false positive US results. [GRAPHIC S] We conclude that combined spiral CT and color Doppler ultrasonograp hy is an effective and relatively non invasive alternative to intraart erial digital angiography for the detection of renal artery stenosis i n a hypertensive population screened for renovascular hypertension.