RENAL SCANNING FOR DETECTION OF RENOVASCULAR HYPERTENSION

¹ Resident in Radiology.
² Associate Professor of Radiology.

To assess the value of the chlormerodrin Hg¹⁹⁷ renal scan in detecting hypertension of renovascular origin, we reviewed the records of all 43 patients with hypertension who had scannings performed during a 15 month period.

Performed without contrast enhancement, scans were interpreted as abnormal if one kidney or a segment of a kidney showed diminished activity when compared to the other. Correlation of the results of the scans with the results of excretory urography, aortography, plasma renin assay, and surgical outcome showed that none of the 20 patients with normal scans had surgically correctable renovascular hypertension, including 1 patient in whom all other screening studies were abnormal. Of the 23 patients with abnormal scans, good correlation with the aortogram was found in 19 of 20, with plasma renin assay results in 10 of 17, and in 3 of 5 patients who had split renal function studies. Of the 7 patients who came to surgery for possible cure of renovascular hypertension, 1 had thrombosis of a renal artery graft. The scan correctly predicted the results found 5-11 months following surgery in the remaining 6 patients.

We believe that the properly performed renal scan provides an often overlooked technically simple screening procedure for detecting renovascular hypertension.

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