Renal Artery Stenosis and Evaluation of the Effect of Endoluminal Dilatation: Comparison of Dynamic CT Scanning and I-131-OIHA Renogram

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Abstract
Percutaneous transluminal dilatation was performed in 16 patients with hypertension and renal artery stenoses. Dynamic CT scanning and an I-131-OIHA renogram was performed before and after dilatation. After the procedure (follow-up greater than or equal to 3 months) the hypertension was assessed clinically as normalized in six, improved in five, and unimproved in five patients. The attenuation difference at dynamic CT scanning between both kidneys at the time of peak enhancement following intravenous bolus injection of contrast material diminished significantly from 16 +/- 4 HU before to 7 +/- 6 HU (P = 0.015) after dilatation in the patient group with cured hypertension, whereas the relative opacification of the poststenotic kidneys increased from 43.6 +/- 2.4% to 47.4 +/- 1.7% (P = 0.014). The results of the Isotope renogram showed a similar increase of the relative function of the poststenotic kidneys from 33 +/- 5% to 38 +/- 7% (P = 0.227) and significant improvement of the clearance from 112 +/- 34 to 175 +/- 48 ml/min/1.73m2 (P = 0.040). The results of both techniques did not significantly change in the group of patients with only moderate improvement of hypertension. Deterioration of the results occurred in those patients in which the hypertension remained unchanged.
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