THE KIDNEYS AND HYPERTENSION
Guest Editor: Blaufox M. D. 

The Quarterly Journal of Nuclear Medicine 2002 December;46(4):283-94

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Renovascular hypertension. Radiographic methods

Loney E. L., Farrant J., Watkinson A.

Department of Radiology Royal Free Hospital NHS Trust, London, UK

In ­recent ­years the ­choice of radio­graph­ic meth­ods avail­able in the inves­ti­ga­tion of ren­o­vas­cu­lar hyper­ten­sion has ­increased sig­nif­i­cant­ly. It can be dif­fi­cult for the cli­ni­cian to ­decide ­which ­patients ­will ben­e­fit ­from screen­ing and ­which modal­ity to ­choose. This arti­cle ­seeks to ­address ­some of ­these ­issues. The ­role of the ­plain radio­graph and intra­ve­nous uro­gram are brief­ly men­tioned. Doppler ultra­sound, MR, CT and con­ven­tion­al arter­i­og­ra­phy are dis­cussed in ­detail. Their advan­tag­es and pit­falls are ­reviewed. In our insti­tu­tion ultra­sound to doc­u­ment ­renal ­size and gad­o­lin­ium-­enhanced 3-D MRA are our rec­om­mend­ed ­first-­line inves­ti­ga­tions ­unless MRA is con­tra­in­di­cat­ed. Digital sub­trac­tion arter­i­og­ra­phy is ­reserved for the ­small sub­group in ­which MRA ­fails to ­obtain an ­answer, for what­ev­er rea­son.