A clinical study on selective renal arteriography

Han, M C; Yoon, Y; Ha, S W; Kim, C W

Abstract

Selective renal arteriography is a highly valuable diagnostic procedure for the detection and exact evaluationof various renal disease, especially differentiation of benign and malignant lesion. Since Abrams had advocatedepinephrine pharmacoangiography, this has been widely used for diagnosis of malignant tumors. Authors analyzedangiographic findings as well as clinical, surgical and pathological findings in 79 cases that were studies withsuspection of renal disease during last 5 years, from August 1971 to October 1976 at Department of Radiology,Seoul National university Hospital. Aortogram, selective renal arteriogram and epinephrine pharmacoangiogram werecomprehensively analyzed. The results are as follows ; 1. The most frequent diagnosis was renal cell carcinomabeing 14 cases, and then simple cyst 12 cases, renal atrophy 7 cases, hypoplasia and agenesis 7 cases,transitional cell carcinoma 5 cases, hydronephrosis 5 cases and renal artery stenosis 5 cases, in order offrequency. 2. The diagnostic accuracy of arteriography in this series was 92,7% (76 over 82). 3. Six mis-diagnosedcases were avacular hypernephroma looked like renal cyst, transitional cell carcinoma without any tumorvascularity, rupture of the renal pelvis with formation of peripelvic urinoma which simulated avacular tumor,renal infarction with increased vascularity, tuberculosis with large cavity, and xanthogranulomatouspyelonephritis with slightly increased vascularity. 4. Epinephrine pharmacoangiography had an excellent diagnosticvalue, showing normal response in 36 of 38 studies in normal or benign lesions and abnormal response in 18 of 19malignant tumors. It appears clear that selective angiography is a saft and excellent procedure in the earlydetection and accurate diagnosis of the benign and malignant renal disease.