Advantages of standardized criteria for the interpretation of angiotensin-converting enzyme inhibition renography.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Standard

Advantages of standardized criteria for the interpretation of angiotensin-converting enzyme inhibition renography. / Thorsson, Ola; Bjuväng, Agneta; Granerus, Göran.

I: Nuclear Medicine Communications, Vol. 30, 2009, s. 449-454.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Harvard

APA

CBE

MLA

Vancouver

Author

RIS

TY - JOUR

T1 - Advantages of standardized criteria for the interpretation of angiotensin-converting enzyme inhibition renography.

AU - Thorsson, Ola

AU - Bjuväng, Agneta

AU - Granerus, Göran

PY - 2009

Y1 - 2009

N2 - BACKGROUND: The aim of this study was to evaluate the efficiency of captopril renography to detect renovascular hypertension (RVH) using the standardized test criteria established at the consensus conference in Santa Fe 1995. The evaluation was made prospectively and in a clinical situation. METHODS: Renal scintigraphy was performed with Tc-MAG3 according to a 2-day protocol in patients receiving 25 mg captopril 1 h before the test. A baseline study was added only in patients showing abnormal findings in the captopril-stimulated study. All tests were re-evaluated according to the consensus criteria by two nuclear medicine specialists who were unaware of the original evaluation that was made by different doctors on duty at the nuclear medicine section at the time. RESULTS: Using a 12-month clinical follow-up as a reference, 16 patients in a group of 164 hypertensive patients had RVH, that is, a prevalence of 10%. The re-evaluation and original evaluation indicated a sensitivity of 94 versus 100%, specificity of 97 versus 88%, accuracy of 97 versus 89%, positive predictive value of 83 versus 47%, and negative predictive value of 99 versus 100%. In 15 studies, results from the two evaluations were discordant and in 14 of these studies an originally false positive or intermediate study was re-evaluated as negative. The test result was highly decisive in the future management of patients, minimizing the number of renal angiograms that had to be performed and initiating a search for other causes of secondary hypertension. CONCLUSION: Captopril renography is a useful and reliable test in patients with suspicion of RVH. Strict adherence to the diagnostic criteria and recommendations from the 1995 consensus conference further improved the performance of the test compared with clinical follow-up.

AB - BACKGROUND: The aim of this study was to evaluate the efficiency of captopril renography to detect renovascular hypertension (RVH) using the standardized test criteria established at the consensus conference in Santa Fe 1995. The evaluation was made prospectively and in a clinical situation. METHODS: Renal scintigraphy was performed with Tc-MAG3 according to a 2-day protocol in patients receiving 25 mg captopril 1 h before the test. A baseline study was added only in patients showing abnormal findings in the captopril-stimulated study. All tests were re-evaluated according to the consensus criteria by two nuclear medicine specialists who were unaware of the original evaluation that was made by different doctors on duty at the nuclear medicine section at the time. RESULTS: Using a 12-month clinical follow-up as a reference, 16 patients in a group of 164 hypertensive patients had RVH, that is, a prevalence of 10%. The re-evaluation and original evaluation indicated a sensitivity of 94 versus 100%, specificity of 97 versus 88%, accuracy of 97 versus 89%, positive predictive value of 83 versus 47%, and negative predictive value of 99 versus 100%. In 15 studies, results from the two evaluations were discordant and in 14 of these studies an originally false positive or intermediate study was re-evaluated as negative. The test result was highly decisive in the future management of patients, minimizing the number of renal angiograms that had to be performed and initiating a search for other causes of secondary hypertension. CONCLUSION: Captopril renography is a useful and reliable test in patients with suspicion of RVH. Strict adherence to the diagnostic criteria and recommendations from the 1995 consensus conference further improved the performance of the test compared with clinical follow-up.

U2 - 10.1097/MNM.0b013e328329fdd7

DO - 10.1097/MNM.0b013e328329fdd7

M3 - Article

VL - 30

SP - 449

EP - 454

JO - Nuclear Medicine Communications

JF - Nuclear Medicine Communications

SN - 1473-5628

ER -