Imaging techniques in the evaluation of pediatric hypertension

Siegel, Marilyn J.; Amour, Thomas E. St.; Siegel, Barry A.

doi:10.1007/bf00866888

Cited by 23 publications

(7 citation statements)

References 63 publications

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“…Doppler ultrasonography can be used to demonstrate changes in flow in renal arteries due to stenotic lesions [58,59]. Computed duplex sonography can measure blood flow velocities and absolute renal blood flow volume [60].…”

Section: Doppler and Computed Duplex Sonographymentioning

confidence: 99%

The diagnosis of renovascular disease

Dillon

1997

Pediatric Nephrology

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Renovascular disease is an important cause of remediable hypertension in childhood. Specific diagnostic procedures currently available to investigate affected children include Doppler and computed duplex sonography, angiotensin converting enzyme (ACE) inhibitor sensitisation of radionuclide imaging, captopril-stimulated plasma renin activity, hypotensive responses to ACE inhibitor, renal vein renin measurements, renal angiography and magnetic resonance angiography. Carbon dioxide digital subtraction angiography and computerised tomographic and spiral angiography are also available and may play an important future role in such evaluations. Utilising this array of procedures it is usually possible to define the anatomical and functional status of the renal vasculature and be guided towards the most appropriate therapeutic manoeuvres.

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Section: Doppler and Computed Duplex Sonographymentioning

confidence: 99%

The diagnosis of renovascular disease

Dillon

1997

Pediatric Nephrology

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“…The gold standard for diagnosis of RAS remains selective arteriography, and invasive procedure [1,4,5]. Noninvasive methods, such as Doppler ultrasonography (US), are now routinely performed in adults [4,6].…”

Section: Introductionmentioning

confidence: 99%

Value of Doppler ultrasound for the diagnosis of renal artery stenosis in children

Brun

Kchouk

Mouchet

et al. 1997

Pediatric Nephrology

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To evaluate the reliability of Doppler ultrasonography (US) in identifying children with renal artery stenosis (RAS) among those with hypertension, we compared Doppler US results in 22 hypertensive children (mean age 8.9 +/- 4.3 years), with (13 cases) and without RAS at angiography, and in 33 normotensive children (mean age 8.8 +/- 4.7 years). We observed 2 false-negatives and 2 false-positives with Doppler US. Of the 2 false-negative diagnoses, I had RAS on an accessory renal artery located behind a normal upper polar artery and the other was observed in a patient with bilateral multiple stenosis of the very distal segments of renal arteries. The 2 false-positive diagnoses were due to sinuous left renal artery and to technical reasons, respectively. In another patient, Doppler US showed a tight RAS, while arteriography was normal. RAS was subsequently confirmed by a second arteriography. Peak systolic velocity values of Doppler US were significantly higher in patients with proven angiographic RAS (3.44 +/- 0.66 m/s) than in hypertensive patients with normal renal arteries at angiography (0.99 +/- 0.35 m/s, P < 0.0001) and normotensive healthy children (1.04 +/- 0.23 m/s, P < 0.0001). With the use of multiple views, and the experience acquired with practice, false-negatives or false-positives due to the geometry of the renal artery can be avoided. Nevertheless, very distal stenosis can be missed by Doppler US.

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“…The Abnormal masses of thyroid origin can be distinguished as such by their attenuation value and by their continuity with the thyroid gland [2]. Both of these criteria were present in this case.…”

Section: Discussionmentioning

confidence: 48%