Top

Pediatric Radiology

Published in:

01-12-2009 | Original Article

Pediatric renovascular hypertension in Thailand: CT angiographic findings

Authors: Pannee Visrutaratna, Tanop Srisuwan, Chusak Sirivanichai

Published in: Pediatric Radiology | Issue 12/2009

Abstract

Background

Renovascular disease is an uncommon but important cause of hypertension in children. When unrecognized and untreated, renovascular hypertension in children can have serious complications.

Objective

To review the causes of renovascular hypertension and computed tomography angiographic (CTA) findings in children and adolescents.

Materials and methods

Twenty-eight CTAs from January 2004 to March 2008 of 23 children and adolescents with hypertension were reviewed for the causes and CTA findings.

Results

Nine of the 23 children (39%) had abnormal renal arteries with or without abnormal abdominal aortas. Four of these children had Takayasu arteritis, one had moyamoya disease, and one had median arcuate ligament syndrome. One with chronic pyelonephritis had severe stenosis of the proximal right renal artery. The other two children had renal artery stenosis with a nonspecific cause. One child with a normal abdominal aorta and renal arteries had a right suprarenal mass. On pathological examination a ganglioneuroma was found.

Conclusion

CTA can help in diagnosis of renovascular hypertension in children and adolescents. Although CTA is not a screening modality, it is appropriate in some situations.

Tullus K, Brennan E, Hamilton G et al (2008) Renovascular hypertension in children. Lancet 371:1453–1463CrossRefPubMed

Stanley JC, Criado E, Upchurch GR Jr et al (2006) Pediatric renovascular hypertension: 132 primary and 30 secondary operations in 97 children. J Vasc Surg 44:1219–1228CrossRefPubMed

Vade A, Agrawal R, Lim-Dunham J et al (2002) Utility of computed tomographic renal angiogram in the management of childhood hypertension. Pediatr Nephrol 17:741–747CrossRefPubMed

Shroff R, Roebuck DJ, Gordon I et al (2006) Angioplasty for renovascular hypertension in children: 20-year experience. Pediatrics 118:268–275CrossRefPubMed

Kumar P, Arora A, Kher V et al (1996) Malignant hypertension in children in India. Nephrol Dial Transplant 11:1261–1266PubMed

Sabharwal R, Vladica P, Coleman P (2007) Multidetector spiral CT renal angiography in the diagnosis of renal artery fibromuscular dysplasia. Eur J Radiol 61:520–527CrossRefPubMed

Beregi JP, Louvegny S, Gautier C et al (1999) Fibromuscular dysplasia of the renal arteries: comparison of helical CT angiography and arteriography. AJR 172:27–34PubMed

Bayazit AK, Yalcinkaya F, Cakar N et al (2007) Reno-vascular hypertension in childhood: a nationwide survey. Pediatr Nephrol 22:1327–1333CrossRefPubMed

McCulloch M, Andronikou S, Goddard E et al (2003) Angiographic features of 26 children with Takayasu’s arteritis. Pediatr Radiol 33:230–235PubMed

10.

Paul JF, Fiessinger JN, Sapoval M et al (2001) Follow-up electron beam CT for the management of early phase Takayasu arteritis. J Comput Assist Tomogr 25:924–931CrossRefPubMed

11.

Gotway MB, Araoz PA, Macedo TA et al (2005) Imaging findings in Takayasu’s arteritis. AJR 184:1945–1950PubMed

12.

Samarkos M, Loizou S, Vaiopoulos G et al (2005) The clinical spectrum of primary renal vasculitis. Semin Arthritis Rheum 35:95–111CrossRefPubMed

13.

Togao O, Mihara F, Yoshiura T et al (2004) Prevalence of stenoocclusive lesions in the renal and abdominal arteries in moyamoya disease. AJR 183:119–122PubMed

14.

Choi Y, Kang BC, Kim KJ et al (1997) Renovascular hypertension in children with moyamoya disease. J Pediatr 131:258–263CrossRefPubMed

15.

Yamada I, Himeno Y, Matsushima Y et al (2000) Renal artery lesions in patients with moyamoya disease: angiographic findings. Stroke 31:733–737PubMed

16.

Ilica AT, Kocaoglu M, Bilici A et al (2007) Median arcuate ligament syndrome: multidetector computed tomography findings. J Comput Assist Tomogr 31:728–731PubMed

17.

Thony F, Baguet JP, Rodiere M et al (2005) Renal artery entrapment by the diaphragmatic crus. Eur Radiol 15:1841–1849CrossRefPubMed

18.

Wittenberg G, Kenn W, Tschammler A et al (1999) Spiral CT angiography of renal arteries: comparison with angiography. Eur Radiol 9:546–551CrossRefPubMed

19.

Johnson PT, Halpern EJ, Kuszyk BS et al (1999) Renal artery stenosis: CT angiography— comparison of real-time volume-rendering and maximum intensity projection algorithms. Radiology 211:337–343PubMed

20.

Fraioli F, Catalano C, Bertoletti L et al (2006) Multidetector-row CT angiography of renal artery stenosis in 50 consecutive patients: prospective interobserver comparison with DSA. Radiol Med 111:459–468CrossRefPubMed

21.

Moukaddam H, Pollak J, Scoutt LM (2007) Imaging renal artery stenosis. Ultrasound Clin 2:455–475CrossRef

22.

Paterson A, Frush DP (2007) Dose reduction in paediatric MDCT: general principles. Clin Radiol 62:507–517CrossRefPubMed

23.

Frush DP (2008) Pediatric abdominal CT angiography. Pediatr Radiol 38:S259–S266CrossRefPubMed

24.

Sahani D, Kalva SP, Hahn PF et al (2007) 16-MDCT angiography in living kidney donors at various tube potentials: impact on image quality and radiation dose. AJR 188:115–120CrossRefPubMed

25.

Vo NJ, Hammelman BD, Racadio JM et al (2006) Anatomic distribution of renal artery stenosis in children: implications for imaging. Pediatr Radiol 36:1032–1036CrossRefPubMed

26.

Chan FP, Rubin GD (2005) MDCT angiography of pediatric vascular diseases of the abdomen, pelvis, and extremities. Pediatr Radiol 35:40–53CrossRefPubMed

Title: Pediatric renovascular hypertension in Thailand: CT angiographic findings
Authors: Pannee Visrutaratna
Tanop Srisuwan
Chusak Sirivanichai
Publication date: 01-12-2009
Publisher: Springer-Verlag
Published in: Pediatric Radiology / Issue 12/2009
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-009-1380-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Pediatric renovascular hypertension in Thailand: CT angiographic findings

Abstract

Background

Objective

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2009

Brain malformations associated with epignathus: a clue for the correct prenatal diagnosis

Periventricular leukomalacia in preterm children: assessment of grey and white matter and cerebrospinal fluid changes by MRI

Soccer injuries in children

Perineal US in the diagnosis of a prostatic utricle cyst in an infant

Extraosseous Ewing sarcoma of the thyroid gland

A case of relapsing flitting bilateral idiopathic orbital inflammation