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2 November 2004, Vol 141, No. 9>
Articles | 2 November 2004

Accuracy of Computed Tomographic Angiography and Magnetic Resonance Angiography for Diagnosing Renal Artery Stenosis

G. Boudewijn C. Vasbinder, MD, PhD; Patricia J. Nelemans, MD, PhD; Alfons G.H. Kessels, MD, MSc; Abraham A. Kroon, MD, PhD; Jeffrey H. Maki, MD, PhD; Tim Leiner, MD, PhD; Frederik J.A. Beek, MD, PhD; Michael B.J.M. Korst, MD; Karin Flobbe, PhD; Michiel W. de Haan, MD, PhD; Willem H. van Zwam, MD; Cornelis T. Postma, MD, PhD; M. G. Myriam Hunink, MD, PhD; Peter W. de Leeuw, MD, PhD; Jos M.A. van Engelshoven, MD, PhD, Renal Artery Diagnostic Imaging Study in Hypertension (RADISH) Study Group*
[+] Article and Author Information

From Maastricht University Hospital, Maastricht; University Medical Center St. Radboud, Nijmegen; Jeroen Bosch Medical Center, 's Hertogenbosch; St. Elisabeth Hospital, Tilburg; University Medical Center, Utrecht; and Máxima Medical Center, Veldhoven.


Grant Support: By the Dutch Health Care Insurance Board (OG 97-003).

Potential Financial Conflicts of Interest: Grants received: J.H. Maki (U.S. Department of Veterans Affairs), M.G.M. Hunink (Dutch Health Care Insurance Board).

Requests for Single Reprints: G. Boudewijn C. Vasbinder, MD, PhD, Cardiovascular Research Institute Maastricht (CARIM), Department of Radiology, Maastricht University Hospital, PO Box 5800, NL-6202 AZ Maastricht, the Netherlands; e-mail, vasbinder@rad.unimaas.nl.

Current Author Addresses: Drs. Vasbinder, Leiner, Flobbe, de Haan, van Zwam, and van Engelshoven: Cardiovascular Research Institute Maastricht (CARIM), Department of Radiology, Maastricht University Hospital, PO Box 5800, NL-6202 AZ Maastricht, the Netherlands.

Dr. Nelemans: Department of Epidemiology, Maastricht University, P. Debyeplein 1, NL-6229 HA Maastricht, the Netherlands.

Dr. Kessels: Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Hospital, PO Box 5800, NL-6202 AZ Maastricht, the Netherlands.

Drs. Kroon and de Leeuw: Department of Internal Medicine, Maastricht University Hospital, PO Box 5800, NL-6202 AZ Maastricht, the Netherlands.

Dr. Maki: Department of Radiology, Puget Sound Veterans Affairs Health Care System, 1660 South Columbian Way, Seattle, WA 98108-1597.

Dr. Beek: Department of Radiology, University Medical Center Utrecht, PO Box 90000, NL-3509 AA Utrecht, the Netherlands.

Dr. Korst: Department of Radiology, Jeroen Bosch Hospital, PO Box 90153, NL-5200ME 's-Hertogenbosch, the Netherlands.

Dr. Postma: Department of Internal Medicine, University Medical Center St. Radboud, Geert Grooteplein-Zuid 10, NL-6525 GA Nijmegen, the Netherlands.

Dr. Hunink: Department of Epidemiology and Biostatistics, Erasmus Medical Center, Dr. Molewaterplein 40, NL-3015 GD Rotterdam, the Netherlands.

Author Contributions: Conception and design: G.B.C. Vasbinder, P.J. Nelemans, A.G.H. Kessels, A.A. Kroon, K. Flobbe, M.W. de Haan, M.G.M. Hunink, P.W. de Leeuw, J.M.A. van Engelshoven.

Analysis and interpretation of the data: G.B.C. Vasbinder, P.J. Nelemans, A.G.H. Kessels, A.A. Kroon, J.H. Maki, T. Leiner, F.J.A. Beek, M.B.J.M. Korst, K. Flobbe, M.W. de Haan, W.H. van Zwam, M.G.M. Hunink, P.W. de Leeuw, J.M.A. van Engelshoven.

Drafting of the article: G.B.C. Vasbinder, P.J. Nelemans, A.G.H. Kessels, A.A. Kroon, J.H. Maki, T. Leiner.

Critical revision of the article for important intellectual content: G.B.C. Vasbinder, P.J. Nelemans, A.G.H. Kessels, A.A. Kroon, J.H. Maki, T. Leiner, F.J.A. Beek, M.B.J.M. Korst, M.W. de Haan, W.H. van Zwam, C.T. Postma, M.G.M. Hunink, P.W. de Leeuw, J.M.A. van Engelshoven.

Final approval of the article: G.B.C. Vasbinder, P.J. Nelemans, A.G.H. Kessels, A.A. Kroon, J.H. Maki, T. Leiner, F.J.A. Beek, M.B.J.M. Korst, K. Flobbe, M.W. de Haan, W.H. van Zwam, C.T. Postma, M.G.M. Hunink, P.W. de Leeuw, J.M.A. van Engelshoven.

Provision of study materials or patients: G.B.C. Vasbinder, P.J. Nelemans, A.A. Kroon, M.W. de Haan, C.T. Postma, P.W. de Leeuw, J.M.A. van Engelshoven.

Statistical expertise: P.J. Nelemans, A.G.H. Kessels.

Obtaining of funding: P.J. Nelemans, A.G.H. Kessels, P.W. de Leeuw, J.M.A. van Engelshoven.

Administrative, technical, or logistic support: G.B.C. Vasbinder, T. Leiner, K. Flobbe.

Collection and assembly of data: G.B.C. Vasbinder, T. Leiner, K. Flobbe, P.W. de Leeuw.


Ann Intern Med. 2004;141(9):674-682. doi:10.7326/0003-4819-141-9-200411020-00007
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We performed a prospective comparative study among CTA, MRA, and the reference standard, DSA, for the detection of renal artery stenosis. Each included patient underwent all 3 diagnostic tests.

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Figures

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Figure 1.
Flow of patients through the study.

*The 2 centers that recruited most of the participants included them consecutively. The other centers used nonsystematic convenience samples. Therefore, the exact number of eligible patients is not known. † Reasons for exclusion are given in Appendix Table 2 . ‡ The numbers of results presented here are the sum of all computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) observers, respectively. RAS = renal artery stenosis.

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Figure 2.
Receiver-operating characteristic curves.

Curves are shown for the 3 computed tomographic angiography (CTA) observers (A through C) and the 3 magnetic resonance angiography (MRA) observers (D through F). Areas under the curve are 0.84 for CTA–A, 0.76 for CTA–B, 0.84 for CTA–C, 0.75 for MRA–D, 0.76 for MRA–E, and 0.81 for MRA–F.

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NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

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Summary for Patients

Diagnosis of Renal Artery Stenosis

The summary below is from the full report titled “Accuracy of Computed Tomographic Angiography and Magnetic Resonance Angiography for Diagnosing Renal Artery Stenosis.” It is in the 2 November 2004 issue of Annals of Internal Medicine (volume 141, pages 674-682). The authors are G.B.C. Vasbinder, P.J. Nelemans, A.G.H. Kessels, A.A. Kroon, J.H. Maki, T. Leiner, F.J.A. Beek, M.B.J.M. Korst, K. Flobbe, M.W. de Haan, W.H. van Zwam, C.T. Postma, M.G.M. Hunink, P.W. de Leeuw, and J.M.A. van Engelshoven, for the Renal Artery Diagnostic Imaging Study in Hypertension (RADISH) Study Group.

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