Author |
양형인(Hyung In Yang),이동수(Dong Soo Lee),김승철(Sung Chul Kim),배상균(Sang Kyun Bae),최창운(Chang Woon Choi),정준기(June Key Chung),김성권(Suhng Gwon Kim),이명철(Myung Chul Lee),이정상(Jung Sang Lee),고창순(Chang Soon Koh), |
Abstract |
To evaluate the sensitivity and specificity of
captopril renal scan for renovascular hypertension, we
employed the captopril renal scan in conjunction with
renal angiography in 81 patients, 159 kidneys, who were
referred to evaluate the cause of hypertension. We
defined the renovascular hypertension by the criteria
of demonstration of renal artery stenosis by
angiography, and improvement or cure of hypertension by
revascularization. Visual and quantitative evaluation
of Tc-99m-DTPA renal scan was performed pre and post
captopril administration. The prevalence rate of
renovascular hypertension was 40% in comparing with
renal angiography, and 70% in confirmed cases. The
causes of renovascular hypertension in 81 patients were
Takayasu's arteritis, fibromuscular dysplasia,
atherosclerosis, essential hypertension, chronic
pyelonephritis etc. The sensitivity and specificity of
captopril renal scan in comparing with renal
angiography were 80%, 86.5%, respectively and also
84.2%, 72.6% in confirmed cases of renovascular
hypertension, respectively. The causes of false
negative cases were nonfunctioning kidney due to
complete obstruction or long duration of disease in
basal scan, segmental branch artery stenosis, unknown
causes, and suspicious true negative cases without
confirmation. The false positive cases were abdominal
aortic stenosis or aneurysm, dehydration, unknown
causes, and suspicious true positive cases. We conclude
that captopril renal scintigraphy is highly sensitive,
reasonably specific diagnostic method and comparable to
other techniques very favorably. |