Imaging Tests for Diagnosis of Renal Artery Stenosis or Occlusion
Test | Advantages | Disadvantages |
|---|---|---|
Noninvasive Fast Generally available | Requires IV iodinated contrast, which may be nephrotoxic | |
Highly accurate Noninvasive Safe in patients with glomerular filtration rate (GFR) > 60 mL/minute and possibly GFR 30–60 mL/minute | Requires gadolinium contrast, which increases risk of nephrogenic systemic fibrosis | |
Noninvasive Provides information about renal function | Operator-dependent, time-consuming, and not always available; limited accuracy in patients with obesity | |
Radionuclide renography | Noninvasive Images renal blood flow | Usually not used as the initial test |
Arteriography | Diagnostic gold standard Provides anatomic detail for surgical and invasive radiologic procedures | Invasive Risk of atheroembolism (due to arterial catheterization) and contrast-induced nephropathy |
Uses less iodinated contrast than arteriography | Invasive Requires iodinated contrast, but in smaller amounts than arteriography | |
Carbon dioxide angiography | No need for contrast agent | Relatively unavailable |