Clemente Alberto, Macchi Veronica, Porzionato Andrea, Stecco Carla, De Caro Raffaele, Morra Aldo
Department of Radiology, University of Ferrara, Ferrara, Italy.
Surg Radiol Anat. 2009 Jan;31(1):25-9. doi: 10.1007/s00276-008-0384-8. Epub 2008 Jul 23.
Fibromuscular dysplasia (FMD) is one of the most common causes of renovascular hypertension in children and women. It is characterized by short multiple stenoses alternated to focal expansions that usually involve the lateral third of the renal artery. Digital subtraction angiography is considered the most accurate method in the diagnosis of renal artery FMD. An indirect sign of FMD-the notches on the ureter secondary to the hypertrophy of the branches of ureteric arteries "climbing" along the ureters-can be visualised during urography. We report the case of a 38-years-old woman with hypertension and no history of familiar predisposition, in which the multidetector computed tomography angiography was able to show both direct and indirect radiological signs of renal artery FMD. 2D and 3D visualisations are useful to suggest the diagnosis of FMD and in the follow-up in patients who underwent to percutaneous transluminal angioplasty.
纤维肌性发育不良(FMD)是儿童和女性肾血管性高血压最常见的病因之一。其特征是多发短段狭窄与局灶性扩张交替出现,通常累及肾动脉外侧三分之一。数字减影血管造影被认为是诊断肾动脉FMD最准确的方法。FMD的一个间接征象——输尿管动脉分支沿输尿管“攀爬”导致输尿管肥大继发的输尿管切迹——可在尿路造影时显示。我们报告一例38岁高血压女性病例,其无家族易患史,多层螺旋计算机断层血管造影能够显示肾动脉FMD的直接和间接影像学征象。二维和三维可视化有助于提示FMD的诊断以及对接受经皮腔内血管成形术患者的随访。