THE EFFICACY OF MULTI-DETECTOR COMPUTED ANGIOGRAPHY IN DELINATION OF RENO-VASCULAR PATHOLOGY

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.