[Value of spiral computed tomography with three-dimensional reconstruction in the investigation of renal arteries. An initial clinical experience apropos of 16 cases].

Renovascular hypertension represents 1 to 2% of all causes of hypertension. It is important to make the diagnosis as radical treatment may be proposed. Digitised arteriography is the reference diagnostic method. Spiral angiotomography is a new diagnostic technique for the investigation of the aorta and its branches. The examination was performed with a Siemens Somatom Plus S spiral scanner. The images were acquired after intravenous injection of 140 ml of iodine contrast medium in the forearm. Three dimensional reconstruction of the renal arteries may be performed secondarily. The results of 16 examinations were compared with those of arteriography. Nine stenoses were suspected after spiral angiotomography and confirmed in 7 cases by arteriography (sensitivity 100%; specificity 77%); two adrenal abnormalities were also detected by spiral tomography. In this series, spiral angiotomography detected all cases of renal artery stenosis with good specificity. Moreover, this investigation also allowed evaluation of the adrenal glands. The simple, non-invasive and polyvalent nature of this method should, if the results are confirmed in a large series, lead to its use as the investigation of first intention for suspected secondary causes of hypertension.