A Prospective Study of Carbon Dioxide—Digital Subtraction vs Standard Contrast Arteriography in the Evaluation of the Renal Arteries
David Z. Schreier, MD;
Fred A. Weaver, MD;
Joseph Frankhouse, MD;
George Papanicolaou, MD;
Ernest Shore, MD;
Albert E. Yellin, MD;
Frances Harvey, RN
Arch Surg. 1996;131(5):503-508.
Abstract
| |
Objective
To compare carbon dioxide—digital subtraction arteriographic (CO2-DSA) images of renal artery anatomy with standard iodinated contrast arteriographic (ICA) images.
Design
One hundred patients with vascular disease who required abdominal aortography were evaluated by both CO2-DSA and ICA modalities. Two blinded readers interpreted arteriograms for the degree of renal artery stenosis, and a third reader was employed to resolve differences in reader interpretations.
Setting
University medical center.
Main Outcome Measures
The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy were calculated for the ability of CO2-DSA to demonstrate a 60% or greater stenosis of the main renal artery; K values for CO2-DSA and ICA were calculated to assess intraobserver variability.
Results
Of the 200 main renal arteries imaged, 17 (9 by means of CO2-DSA, 8 by means of ICA) were eliminated because of inadequate visualization of the renal artery. In identifying a renal artery stenosis of 60% or greater, CO2DSA had a sensitivity of 0.83, specificity of 0.99, positive predictive value of 0.94, and negative predictive value of 0.98. The overall accuracy was 0.97. The K statistic was 0.75 for CO2-DSA and 0.70 for ICA, hence, the variation in the interpretations of CO2-DSA and ICA were comparable.
Conclusion
Images by means of of CO2-DSA accurately reflect pathologic changes in renal arteries and are thus useful in the diagnosis of clinically occult occlusive renal artery disease in patients at risk of contrast medium—related nephrotoxicity.
(Arch Surg. 1996;131:503-508)
Author Affiliations
From the Department of Surgery, University of Southern California School of Medicine, Los Angeles.
Footnotes
Deceased.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Carbon dioxide as a valuable contrast agent for identifying iatrogenic arteriovenous fistulas in transplanted kidneys
Nicolini et al.
Nephrol Dial Transplant 2003;18:2189-2192.
FULL TEXT
Demonstration of renal arterial anatomy and tumour neovascularity for vascular mapping of renal cell carcinoma: the value of CO2 angiography
Sandhu et al.
Br. J. Radiol. 2003;76:89-93.
ABSTRACT
| FULL TEXT
|
