Document Detail


Detection of renal artery stenosis: prospective comparison of captopril-enhanced Doppler sonography, captopril-enhanced scintigraphy, and MR angiography.
MedLine Citation:
PMID:  11641186     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of our study was to compare the value of captopril-enhanced Doppler sonography, captopril-enhanced renal scintigraphy, and gadolinium-enhanced MR angiography for detecting renal artery stenosis. SUBJECTS AND METHODS: Forty-one patients with suspected renovascular hypertension were prospectively examined with captopril-enhanced Doppler sonography, captopril-enhanced renal scintigraphy, gadolinium-enhanced MR angiography, and catheter angiography. The sensitivity and specificity of each technique for detecting renal artery stenosis measuring 50% or greater and 70% or greater were compared using the McNemar test. Positive and negative predictive values were estimated for populations with 5% and 30% prevalence of renal artery stenosis. Kappa values for interobserver agreement were assessed for both gadolinium-enhanced MR angiography and catheter angiography. RESULTS: For detecting renal artery stenosis measuring 50% or greater, the sensitivity of gadolinium-enhanced MR angiography (96.6%) was greater than that of captopril-enhanced Doppler sonography (69%, p = 0.005) and captopril-enhanced renal scintigraphy (41.4%, p = 0.001). No significant difference in specificity was observed among modalities. For renal artery stenosis measuring 50% or greater, positive and negative predictive values were respectively 62% and 86% for captopril-enhanced Doppler sonography, 49% and 76% for captopril-enhanced renal scintigraphy, and 53% and 98% for gadolinium-enhanced MR angiography. Interobserver agreement was high for both gadolinium-enhanced MR angiography (kappa = 0.829) and catheter angiography (kappa = 0.729). CONCLUSION: Gadolinium-enhanced MR angiography is the most accurate noninvasive modality for detecting renal artery stenosis greater than or equal to 50%. The use of captopril-enhanced Doppler sonography in combination with gadolinium-enhanced MR angiography for identifying renal artery stenosis needs to be evaluated with a cost-effectiveness analysis.
Authors:
S D Qanadli; G Soulez; E Therasse; V Nicolet; S Turpin; D Froment; M Courteau; M C Guertin; V L Oliva
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  177     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-10-19     Completed Date:  2001-12-04     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1123-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, CHUM, Hôpital Notre-Dame, 1560 Sherbrooke St. E., Montréal, Quebec H2L 4M1, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography
Captopril / diagnostic use*
Female
Humans
Hypertension, Renovascular / diagnosis
Image Enhancement*
Magnetic Resonance Angiography*
Male
Middle Aged
Observer Variation
Prospective Studies
Radioisotope Renography*
Renal Artery Obstruction / diagnosis*
Sensitivity and Specificity
Technetium Tc 99m Mertiatide / diagnostic use
Ultrasonography, Doppler*
Chemical
Reg. No./Substance:
125224-05-7/Technetium Tc 99m Mertiatide; 62571-86-2/Captopril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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