Renal arteries CT is a noninvasive study of arterial renal blood flow by means of high-speed scanning of renal vessels at the height of their contrast. CT angiography of the renal arteries is performed to study the architectonics and identify congenital vascular anomalies, tumor compression or intraluminal stenosis of the renal arteries, kidney infarction, etc. The possibility of further multi-plane and three-dimensional reconstruction of the obtained images allows to determine indications with high accuracy and plan angiosurgical intervention on the renal arteries.
Indications
Renal arteries CT is prescribed in the following cases:
- suspected tumors;
- the presence of cystic neoplasms;
- anomalies of kidney development;
- suspected arterial embolism or renal stenosis;
- hydronephrosis – renal arteries CT will show the degree of tissue damage and their blood supply;
- the need to clarify the nature of disorders in the renal arteries;
- severe course of renal tuberculosis, when the issue of the level of resection of the affected organ is being resolved, taking into account its angioarchitectonics;
- arterial hypertension of an unexplained nature or occurring against the background of impaired renal vascular functions;
- traumatic kidney injuries;
- the need to assess blood flow in the transplanted organ.
Also indications for angiography of the renal arteries are the planning of surgical interventions and postoperative monitoring.
What will show
Renal arteries CT allows a specialist:
- consider the structure and condition of the vessels;
- to determine the cause of renal insufficiency, arterial hypertension and other pathologies ;
- differentiate different neoplasms from each other (renal arteries CT helps to distinguish between cysts, tumors, vascular and benign tumors);
- to identify damage to blood vessels or parenchyma (indirectly) with injuries.
Computed tomography of kidney vessels will show:
- the location of large, medium and small vessels;
- bleeding;
- inflammation of the artery walls;
- the presence of blood clots;
- stenosis (narrowing of the vascular lumen);
- occlusion (blockage) of arteries;
- atherosclerosis;
- benign or malignant tumors;
- pathological connections between an artery and a vein (malformation);
- congenital anomalies of the vascular structure (renal arteries CT will show additional arteries in the kidneys and their variants of discharge, aneurysms, fibromuscular stenosis, etc.).
Renal arteries CT allows you to diagnose various diseases with high accuracy, as well as complications that have arisen after organ transplantation: vascular thrombosis of the transplant, bleeding from the area of venous or arterial anastomosis, etc.
In combination with classical CT with contrast, angiography of the renal arteries diagnoses adrenal tumors and metastases, to identify primary tumors of the retroperitoneal space, this study is supplemented with magnified magnetic resonance imaging.
CT of renal arteries with contrast
Angiography of vessels is performed using an iodine-containing coloring agent. Contrast is injected into the vein by the bolus method using an automatic syringe. Before a CT scan of the renal arteries, the patient must donate blood for creatinine level analysis. With elevated indicators, examination is prohibited, since there is a risk of problems with the withdrawal of the drug from the body.
Other contraindications to kidney angiography:
- pregnancy at any time;
- iodine intolerance;
- severe form of renal or hepatic insufficiency;
- pronounced thyrotoxicosis.
In order to pass without negative health consequences, it is necessary to properly prepare for it. If the patient suffers from diabetes mellitus and takes metformin, it is necessary that the endocrinologist cancel or replace this drug with another two days before the angiography of the renal arteries.
4 hours before the examination, it is necessary to abstain from food and liquids. Shortly before leaving the house, you can easily have a snack. Immediately before the procedure, it is necessary to empty the bladder.
Angiography of the renal vessels can affect the composition of breast milk, so nursing mothers are advised to take care of the baby’s nutrition in advance, and after they will have to skip two subsequent feedings, pumping milk.
Method of conducting
If shortly before the CT scan of the renal arteries, the patient underwent ultrasound, MRI or conventional X-ray diagnostics, the doctor should be informed.
Before entering the office, remove all metal objects (accessories, piercings) that can get into the scanning area and distort the images.
During a CT scan of the renal arteries, a person lies on a mobile table in a supine position. For maximum image quality, it is important to remain motionless and follow the commands of the doctor who monitors the procedure from the next room. If discomfort appears, the doctor can be called using a device with an “alarm” button.
The table smoothly slides into the ring of the device. A ring with an X-ray tube and sensors rotates around it, taking a series of pictures in the axial plane. Upon completion of the CT scan of the renal arteries, the equipment is switched off and the patient can stand up.
Since the study of the vascular system of the kidneys is associated with the use of contrast, sometimes side effects are observed – redness of the skin at the injection site, mild nausea, a taste of metal in the mouth, a rush of heat throughout the body, dizziness, general weakness. Do not worry: after a CT scan of the renal arteries, these unpleasant symptoms themselves will pass within a short time.
Also, some people may have:
- swelling of the larynx, face, neck, ears;
- sore throat;
- urticaria;
- skin itching;
- bronchospasm;
- drop in blood pressure.
These are signs of intolerance to iodine-containing medications. Patients with bronchial asthma, iodine allergy and seafood are more at risk of developing such reactions. Therefore, even before the start of the CT procedure of the renal arteries, it is necessary to warn the doctor about the existing health problems.
