Renal Arteries: Technique/ Interpretation

Question 1

pt history

Answer 1

HTN, renovascular htn, often caused from renal a stenosis (2nd to atherosclerosis, fibromuscular dysplasia) or occlusion: results in decreased perfusion

Question 2

mechanism for HTN?

Answer 2

renin: an enzyme that converts angiotensionogen to angiotensin

Question 3

renin happens anytime there’s

Answer 3

renal HTN (coarctation)

Question 4

Techniques

Answer 4

• celiac a and sma
• obtains a psv near sma level
• trv, local renal a
• LRV is landmark for identifying LRA. RRA is anteriorly off ao
• obtain kid size
• obtains psv and edv bilaterally of:
• renal a: prox mid dist
• upper/lower pole of kid in segmental a
• observe for 2ndary renal artery

Question 5

Renal a and kidney a are normally ________ resistance in quality as are: _____,______, and _____.

Answer 5

low
celiac
hepatic
splenic

Question 6

ao is usually ______ resistant in quality, as are a fasting SMA and IMA

Answer 6

higher

Question 7

Renal to Ao Ratio (RAR)

Answer 7

Highest Renal Artery PSV
____________________
Ao PSV

Question 8

Normal RAR

Answer 8

< 3.5

Question 9

Abnormal RAR

Answer 9

> 3.5

suggests > 60% dia reduction

Question 10

Cannot use the RAR:

Answer 10

1. AAA detected
2. if ao psc > 90 m/s or < 40 m/s

• look for renal a psv of > 180 - 200 cm/sec that is also followed by post stenotic turbulence