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Comprehensive Evaluation of Patients with Suspected Renal Hypertension Using MDCT: From Protocol to Interpretation

¹ Department of Radiology, Taichung Veterans General Hospital, No. 160, Sec. 3, Taichung Harbor Rd., Taichung 407, Taiwan, ROC.
² Institute of Clinical Medicine and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.
³ Department of Radiological Technology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
⁴ Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.
⁵ Department of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan.

OBJECTIVE. The objectives of this article are to, first, describe the reasons for and details of the MDCT protocol for patients with suspected renal hypertension; second, explain the importance of comprehensive evaluation by MDCT in patients with suspected renal hypertension; third, review the image appearances of important conditions that may be encountered in the reader's clinical practice; and, fourth, explain what information should be included in a comprehensive MDCT report for patients with suspected renal hypertension.

CONCLUSION. MDCT is widely used for renal artery evaluation in patients with resistant hypertension. Because the regions outside the renal arteries might also have diseases that contribute to the symptoms, a comprehensive interpretation including the renal arteries, renal parenchyma, adrenal glands, and scanned abdomen is very important. The scanning parameters should be adjusted according to the patient's body habitus because some patients with suspected renal hypertension are children or young women. In this article, cases with illustrations showing the process from protocol to interpretation are provided.

Keywords: abdominal imaging • adrenal glands • CT • kidneys • radiation dose • renal artery stenosis • renal hypertension

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