DIAGNOSTIC USEFULNESS OF SPIRAL CT ANGIOGRAPHY IN RENAL ARTERIAL STENOSES

Background: Spiral CT angiography (CTA) is a new technology for vascul ar imaging that has the potential to achieve or even to surpass the di agnostic accuracy of arteriography without its invasiveness and risks. The purpose is to evaluate the accuracy of spiral CT angiography in t he detection of renal artery stenosis. Patients and methods: We studie d prospectively 116 patients with high blood pressure and suspected re nal artery stenosis. Forty-eight patients had renal failure (median va lue of serum creatinine before examination 273 umol/l). CTA was perfor med in all patients and in 29, we performed also an intra-arterial dig ital subtraction angiography (DSA ia). Results: Two hundred and sevent y renal arteries were studied, 73% were normal and 275 with stenosis: 68% grade I, 76% grade II, 9.6% grade III and 5.5% grade IV. Renal art ery stenosis was significantly higher in patients with renal failure t han in patients with no renal failure (45% vs 27%, p = 0.03). In 29 pa tients in whom we performed DSA ia, studied 65 arteries. The CTA showe d the same stenosis grading in 62 arteries and CTA overestimated the g rade of stenosis in three (by CTA stenosis grade I and by DSA ia. arte ries normal). Conclusions: CT angiography is a safer technique, non in vasive and with higher sensitivity and specificity for the diagnosis o f renal artery stenosis, and avoided the discomfort of arteriography.