Radiologic Aspects of Renovascular Hypertension

Abstract

Urograms were analyzed and correlated with arteriographic findings and therapeutic results in order to evaluate the reliability of the urogram screening procedure for unilateral renovascular disease and its usefulness in predicting surgical results. Major urographic features were disparity in renal length, calyceal appearance time, and concentration on late films. Minor urographic features analyzed included ureteral notching, decreased volume of the collecting system, parenchymal atrophy, and renal ptosis. All the major urographic features occurred more frequently in the presence of renovascular disease than in a comparable population of patients with essential hypertension. Delayed appearance time seemed to be the single most valuable urographic feature. The urogram was considered to be a satisfactory method for diagnosing the presence or absence of moderate or severe renovascular disease. Urography alone did not enable discrimination between patients who would respond favorably to surgery and those who would not.