Accuracy of multi-detector computed tomographic angiography assisted by post-processing software for diagnosis atheromatous renal artery stenosis

Diagn Interv Imaging. 2013 Nov;94(11):1123-31. doi: 10.1016/j.diii.2013.05.001. Epub 2013 Sep 3.

Abstract

Purpose: To compare the diagnostic performance of MDCTA versus renal angiography in the detection of>50% renal artery stenosis in patients suspected of reno-vascular hypertension.

Materials and methods: Between January 2005 and January 2010, 92 MDCTA and renal arteriographies were retrospectively analysed. Renal angiographies were read by one interventional radiologist. Three blinded independent readers (two senior radiologists and one technician) scored MDCTA images using three different approaches. Reader 1 scored stenosis using only MPR and MIP. Reader 2 (technician) used only proprietary automatic arterial segmentation software. Reader 3 used the cited software, using manual diameter measurements.

Results: A total of 92 patients, (235 renal arteries) were assessed in which 48 significant stenosis were found by arteriography. Sensitivity, specificity, of MDCTA compared to renal arteriography were respectively per patient for reader 1: (88%; 80%); for reader 2: (58%; 80%); for reader 3: (96%; 90%) (P<.02).

Conclusion: When using automated vessel analysis software edited by a radiologist, MDCTA studies had a Sensibility/Specificity of 96%/90% to detect>50% renal artery stenosis.

Keywords: AVA II; Accuracy; Advance vessel analysis version 2; Arteriography; CI; Confidence intervals; DSA; Digital subtraction angiography; EPR; Electronic patient record; HT; HU; Hounsfield units; Hypertension; LR; Likelihood ratios; MDCTA; Multi-detector CTA; Multidetector computed tomography angiography; RAS; Renal artery stenosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography / methods*
  • Atherosclerosis / complications
  • Atherosclerosis / diagnostic imaging*
  • Cohort Studies
  • Female
  • Humans
  • Image Processing, Computer-Assisted*
  • Male
  • Middle Aged
  • Multidetector Computed Tomography*
  • Renal Artery Obstruction / diagnostic imaging*
  • Renal Artery Obstruction / etiology
  • Reproducibility of Results
  • Retrospective Studies
  • Software*