Noninvasive imaging of the renal arteries

Angiography is the gold standard for imaging of the renal arteries; however, accurate imaging is possible using several noninvasive methods including duplex ultrasonography, spiral CT angiography, and MR angiography. Noninvasive imaging is used most frequently is diagnosing renal artery disease and during the preoperative planning for renal transplant donors and renal cancer surgery. In addition, noninvasive imaging is ideal for surveillance of restenosis following endovascular therapy (percutaneous transluminal angioplasty or stenting) or surgical revascularization. While intravenous digital subtraction angiography is not used often because of poor image quality, it is worth briefly discussing for historical purposes. Factors such as body habitus, renal function, and as institutional experience, expertise, and cost will influence the imaging modality recommended for any given patient.