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Advantages disadvantages of imaging methods used to diagnose renal artery stenosis
What are the advantages and disadvantages of the various imaging methods used to diagnose renal artery stenosis?
Imaging Methods for the Diagnosis of Renal Artery Stenosis
| Method | Advantages | Disadvantages |
|---|---|---|
| Doppler ultrasound | • No ionizing radiation• Low cost | • Operator dependent• Bowel often obscures visualization of entire artery• Can be limited by body habitus• Low sensitivity for detection of accessory renal arteries |
| Computed tomography angiography | • Sensitivity and specificity near 100%• Accurate depiction of accessory renal arteries• Rapid acquisition | • Ionizing radiation• Only anatomic evaluation, cannot assess significance of any renal artery stenosis seen• Requires contrast administration |
| Magnetic resonance angiography | • 95% sensitivity• Lack of radiation | • Can miss small accessory arteries• Lower spatial resolution than computed tomography angiography• Risk of nephrogenic systemic fibrosis with contrast-enhanced techniques |
| Digital subtraction angiography | • Allows for interventional treatment | • Ionizing radiation• Requires contrast administration• Potential complication of groin puncture/vascular access |
| Nuclear Medicine—ACE inhibition renography | • Noninvasive | • Ionizing radiation• Time consuming with scans before and after ACE inhibition |
