Cecile J P, Wallaert C H, Foucart H
Ann Med Interne (Paris). 1980;131(5):266-71.
Renal arteriogram can be obtained by a rapid injection (15-22 ml/s) of a venous bolus of 2-3 ml/kg B.W. of contrast media at 38 p. 100 and followed by an excretory pyelography with early films and wash out by furosemide to determine the functional significance of an eventual stenosis in a hypertensive patient. Analysis of 2 000 such radiological examinations, 475 of which done in hypertensive patients, showed that a stenosis could be adequatly detected in 70 p. cent of the cases when only one arteriographic film was taken and in 95 p. 100 of the cases when 6 films were taken with a film changer. With this latter technique the morphological information was comparable to that obtained with the Seldinger technique. This latter was however necessary to confirm the stenosis preoperatively when only one arteriographic film was taken. Tolerance of the examination was good in spite of transitory heat sensation and headache in 66 p. cent of the cases. The examination of 475 hypertensive patients led to discover 55 renal artery stenosis, 12 of which were functionnal, 4 aneurysms (1 of the renal artery, 2 of the aorta, and 1 of the hepatic artery) and one coarctation.
combined intravenous arteriography and pyelography is a valuable technic, as regards, safety and efficiency in the diagnosis of renovascular hypertension. This warrants a comparison of this technique with the classical diagnostic approach of renovascular hypertension as regards its diagnostic efficiency and cost for the community.
肾动脉造影可通过快速注射（15 - 22毫升/秒）体重每千克2 - 3毫升的造影剂静脉推注，于38页100处进行，随后进行排泄性肾盂造影并拍摄早期影像，再用速尿冲洗，以确定高血压患者中可能存在的狭窄的功能意义。对2000例此类放射学检查进行分析，其中475例为高血压患者，结果显示，仅拍摄一张动脉造影片时，70%的病例能充分检测出狭窄；使用换片机拍摄6张片子时，95%的病例能检测出狭窄。采用后一种技术时，形态学信息与经Seldinger技术获得的信息相当。然而，当仅拍摄一张动脉造影片时，术前仍需采用Seldinger技术来确认狭窄。尽管66%的病例出现短暂的热感和头痛，但检查耐受性良好。对475例高血压患者的检查发现了55例肾动脉狭窄，其中12例有功能障碍，4例动脉瘤（1例肾动脉、2例主动脉和1例肝动脉）以及1例主动脉缩窄。
静脉联合动脉造影及肾盂造影在诊断肾血管性高血压方面，就安全性和有效性而言是一项有价值的技术。这值得将该技术与肾血管性高血压的传统诊断方法在诊断效率和社会成本方面进行比较。
