Diagnosis of renovascular hypertension: feasibility of captopril-sensitized dynamic MR imaging and comparison with captopril scintigraphy

AJR. American Journal of Roentgenology
N GrenierJ Palussière

Abstract

Angiotensin-converting enzyme inhibitors may decrease glomerular filtration rate when a significant renal artery stenosis is present. The purpose of this preliminary study is to evaluate the feasibility of captopril-sensitized, dynamic MR imaging of the kidney in a series of patients with a high suspicion of renovascular hypertension and to compare the results with those of captopril scintigraphy. Fifteen hypertensive patients with renal artery stenosis shown by angiography were studied with sequential gadolinium-enhanced MR imaging after oral administration of 50 mg of captopril, an inhibitor of angiotensin-converting enzyme. Symmetry of onset and evolution of tubular phases between the two kidneys were analyzed, and medullary signal intensity time curves were drawn for each kidney. When asymmetry between kidneys was noted, the same dynamic study was repeated 24 hr later, without captopril sensitization. All patients also underwent renal scintigraphy after administration of captopril to compare captopril-induced changes in both techniques. Three-dimensional time-of-flight MR angiography was also performed on all patients. MR imaging with normal and symmetric tubular phases showed that 11 patients had no impairment of glomerula...Continue Reading

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