APPLICATION OF POST-PROCESSING PROCEDURES IN THE IDENTIFICATION AND QUANTIFICATION OF RENAL ARTERY STENOSIS BY USING MULTI-DETECTOR-ROW SPIRAL CT ANGIOGRAPHY: PP.18.211

Abstract

The stenosis of renal artery can produce a reduced blood flow through the renal artery: this situation causes the kidney to release increased amounts of the hormone rennin with consequent hypertension. The aim of our study was to asses the sensitivity and the diagnostic efficacy of Multi-detector-row spiral CT angiography (MDCTA) in diagnosis of renal artery stenosis (RAS) and to evaluate the various types of reconstruction modalities and their efficacy.

We studied 38 patients (19 males; 19 females, mean age: 56 years) that underwent to CTA to asses renal arteries for suspected RAS. Patients were studied by using a multi-detector-row CT. CT scans were obtained after intravenous bolus administration of 110–140 mL of non-ionic contrast material using a 3–6 mL/sec flow rate. We assessed every patient by using axial scans, multi-planar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR) techniques. For every patients and for each reconstruction modalities, the image quality of main renal artery was scored as 0 for bad quality; 1 for poor quality; 2 for good quality 3 for excellent quality images. Two radiologists reviewed CT images in consensus.

Overall number of renal arteries studied were 66, and we detected 21 RAS. Sensitivity to define the presence of RAS by using MPR, MIP and VR was 63%, 74%, and 95%. Quality images obtained an overall value of 123198, 149198, and 168198 for MPR, MIP and VR respectively. Our data underlined a statistical difference between MPR images and VR images (p < 0.001). Moreover we noticed that the images classified as excellent were obtained from vessel with a 300 Hounsfield units or higher (p < 0.001).