Usefulness of 3-dimensional reconstructed images of renal arteries using rotational digital subtraction angiography

PURPOSE: We assess the feasibility of a 3-dimensional (D) reconstruction technique of rotational digital subtraction angiography (DSA) for visualization of the renal arteries. MATERIALS AND METHODS: We evaluated 28 kidneys in 20 patients. Rotational DSA images were obtained during a deep inspiratory pause after contrast material injection through the renal artery. Acquired data were transferred to an image workstation and reconstructed as 3-D images. Visibility of the main trunk of the renal artery, segmental arteries, interlobar arteries and arcuate arteries was classified as grade 4-excellent, grade 3-good, grade 2-satisfactory and grade 1-poor. The 3-D reconstructed images were compared with conventional 2-D DSA performed just before the rotational DSA. The criteria for evaluation were visibility of the aneurysm neck in 8 cases of aneurysm, delineation of the feeding arteries in 6 cases of renal lesions and visibility of the relationship between renal branches in other cases. RESULTS: Delineation of grades 4 to 1 was 93%, 7%, 0% and 0% for the main renal artery, 66%, 21%, 7% and 6% for segmental arteries, 61%, 11%, 21% and 7% for interlobar arteries, and 36%, 18%, 36% and 10% for arcuate arteries, respectively. The 3-D images had the advantage over 2-D DSA in 75% of cases. In all cases of aneurysm 3-D images were obviously more useful than 2-D DSA. CONCLUSIONS: 3-D images of renal arteries obtained with rotational DSA are considered acceptable for clinical use.