Current methods for the diagnosis of renal artery stenosis.

Purpose. - Today, the methods for detecting renal artery stenosis are numer ous. They lead to the identification either of anatomic stenosis or functio nal stenosis (onset of renin-angiotensin system). The purpose of this revie w is to emphasize the performances, limitations and diagnostic criteria for each technique. Current Knowledge and key points. - For detection of anatomic stenosis, the feasibility of Doppler examination has been increased by the improvement o f US systems and the development of contrast agents. However, the criteria used nowadays still need wider evaluation. Helical CT angiography allows a better detection of accessory arteries and calcifications but MR angiograph y has a better spatial resolution and uses a non-nephrotoxic contrast agent . The performances of these two techniques have never been compared. The ch oice between these techniques depends on the operators' experience and the availability of the systems. For functional stenosis, detection is now base d on captopril-sensitized scintigraphy. Future prospects and projects. - It would be necessary to better compare pe rformances and cost-effectiveness ratios of these methods and of the two im aging strategies (detection of anatomic stenosis versus functional stenoses ). Probably in the future, IMR will gain a major place, providing, in the s ame imaging session, morphologic and functional data. (C) 2001 Editions sci entifiques et medicales Elsevier SAS.