Detection of Segmental Branch Renal Artery Stenosis by Doppler US: A Case Report

  • Chang Kyu Seong (Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine) ;
  • Seung Hyup Kim (Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine) ;
  • Jung Suk Sim (Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine)
  • Received : 2000.06.29
  • Accepted : 2000.12.11
  • Published : 2001.03.31

Abstract

In stenosis of a segmental branch or among multiple renal arteries, Doppler sampling of intrarenal arteries in the upper, mid and lower poles demonstrates strikingly different waveform patterns that might otherwise be overlooked. We report a case of segmental branch renal artery stenosis in which a pulsus parvus et tardus waveform was observed in a segmental branch of a renal artery. In this case, systematic analysis of Doppler waveforms of intrarenal arteries at more than three different locations facilitated a rapid and confident diagnosis of segmental branch renal artery stenosis.

Keywords

Acknowledgement

This study was supported by Seoul National University Hospital Research Fund (02-1997-349-0).

References

  1. Working group on Renovascular Hypertension: Detection, evaluation, and treatment of renovascular hypertension. Arch Intern Med 1987;147:820 
  2. Bookstein JJ. Segmental renal artery stenosis in renovascular hypertension. Radiology 1968;90:1073-1083  https://doi.org/10.1148/90.6.1073
  3. Handa N, Fukunaga R, Etani H, et al. Efficacy of echo-Doppler examination for the evaluation of renovascular disease. Ultrasound Med Biol 1988;14:1-5  https://doi.org/10.1016/0301-5629(88)90157-3
  4. Patriquin HB, Lafortune M, Jequier JC, et al. Stenosis of the renal artery: assessment of slowed systole in the downstream circulation with Doppler sonography. Radiology 1992;184:479-485  https://doi.org/10.1148/radiology.184.2.1620852
  5. Avasthi PS, Voyles WF, Greene ER. Noninvasive diagnosis of renal artery stenosis by echo-Doppler velocimetry. Kidney Int 1984;25:824-829  https://doi.org/10.1038/ki.1984.96
  6. Taylor DC, Kettler MD, Moneta GL, et al. Duplex ultrasound scanning in the diagnosis of renal artery stenosis: a prospective evaluation. J Vasc Surg 1988;7:363-369  https://doi.org/10.1016/0741-5214(88)90156-5
  7. Schwerk WB, Restrepo IK, Stellwaag M, et al. Renal artery stenosis: Grading with image-directed Doppler US evaluation of renal resistive index. Radiology 1994;190:785-790  https://doi.org/10.1148/radiology.190.3.8115628
  8. Eibenberger K, Schima H, Trubel W, et al. Intrarenal Doppler ultrasonography: which vessel should be investigated? J Ultrasound Med 1995;14:451-455  https://doi.org/10.7863/jum.1995.14.6.451
  9. Stavros AT, Parker SH, Yakes WF, et al. Segmental stenosis of the renal artery: pattern recognition of tardus and parvus abnormalities with duplex sonography. Radiology 1992;184:487-492  https://doi.org/10.1148/radiology.184.2.1620853
  10. Desberg AL, Paushter DM, Lammert GK, et al. Renal artery stenosis: evaluation with color Doppler flow imaging. Radiology 1990;177:749-753  https://doi.org/10.1148/radiology.177.3.2243982
  11. Berland LL, Koslin DB, Routh WD, et al. Renal artery stenosis: prospective evaluation of diagnosis with color duplex US compared with angiography. Radiology 1990;174:421-423  https://doi.org/10.1148/radiology.174.2.2404314
  12. Lee SM, Drach GW. Renovascular hypertension from segmental renal artery stenosis: importance of segmental renal vein renin sampling. J Urol 1980;124:704-706  https://doi.org/10.1016/S0022-5347(17)55618-9
  13. Katial R, Ziessman HA. Segmental branch renal artery stenosis diagnosed with captopril renography. J Nucl Med 1992;33:266-268