HELICAL CT-ANGIOGRAPHY OF RENAL-ARTERIES - 2-YEARS OF EXPERIENCE

Purpose: to evaluate the role of helical CT angiography (CTA) in the d etection of renal artery stenosis in hypertensive patients. Materials and Methods: we studied 300 hypertensive patients (50 prospectively an d 250 consecutively) with CTA and arteriography (n = 118). Helical acq uisition (collimation 3 mm; pitch = 1, 20 seconds acquisition time) wa s performed 20-45 seconds after contrast injection (300 mgl/ml; 120ml, 4ml/sec). Transverse axial views and 3D reconstructions were analyzed (360 degrees interpolation algorithm, 1 mm overlapped). Results: in t he prospective series, CTA sensitivity was 100% for main renal artery stenoses and specificity was 98.2%; however 7/32 renal accessory arter ies were not visualized. in the 300 patients studied, seventy-four ste noses were detected. There were 5 false-positive and 5 false-negative studies. Secondary hypertension was detected in 26% of patients (inclu ding 14 cases of adrenal hyperplasia). Conclusion : CTA is a promising technique for the detection of renal artery stenosis in hypertensive patients.