Abstract:
The aim of this study is to detect the accuracy and reliability of multi-detector
computed tomographic angiography in delination of reno-vascular pathologies and to
compare it with the Doppler u/s and conventional angiography.
The experimental study was performed on fifty (50) patients, done as study group,
presented with reno-vascular problems.
CTA performed for all (50) patients and obtained a sensitivity of 96% (revealed 48
patients out of 50), Doppler u/s which is performed also for all (50) patients had a
sensitivity of 56% (revealed 28 patients out of 50) where the conventional angiography
performed only for 8 patient and obtained a sensitivity of 100% (revealed 8 patients
out of 8).
The procedure is confirm by angioplasty (6) patients treatment by medicine (5) patient
and (22) patients by surgery where (7) patients are excluded from donation.
The study shows reliable results in diagnosis of reno-vascular diseases under study by
MDCT Scanner. 90.9% accuracy in detection of renal artery stenosis was recorded
compared to 35.36% for Doppler u/s while only 6 patients were needed to be done by
the conventional angiography and obtained a sensitivity of 100%. 100% accuracy in
evaluation of living renal donar compared to 20% for Doppler u/s where the
conventional angiogram was not used. 100% accuracy in renal vein thrombosis
compared to 50% for Doppler u/s where the conventional angiogram was not used.
100% accuracy in evaluation of the tumor invades the renal venous system compared
to 100% Doppler u/s where the conventional angiogram was not used. 50% accuracy
vi
in evaluation of arteriovenous fistula (in this study between the inferior vena cava
(IVC) and the right renal artery (RRA) compared to zero% for Doppler u/s and 100%
for conventional angiogram.
This thesis provides evidence that MDCTA is a reliable and effective non-invasive
modality for investigation and detection of reno-vascular pathologies and it can
approach and replace invasive cather angiography (conventional angiogram) which
involves intra-arterial injection for contrast materials where intra-venous injection for
contrast materials in CTA and it used as a complementary technique with Doppler u/s,
using Doppler u/s as a primary screening test followed by CTA as a final reliable and
accurate screening modality to overcome Doppler u/s limitation due to patient
conditions, e.g. obesity, gases, and operator dependent procedure.
