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

Thorsson, Ola LU ; Bjuväng, Agneta and Granerus, Göran (2009) In Nuclear Medicine Communications 30. p.449-454
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Nuclear Medicine Communications
volume
30
pages
449 - 454
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000266146800008
  • pmid:19352208
  • scopus:67649669876
ISSN
1473-5628
DOI
10.1097/MNM.0b013e328329fdd7
language
English
LU publication?
yes
id
b0c70c18-40e9-4c18-86dd-9b141fe903c0 (old id 1392332)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19352208?dopt=Abstract
date added to LUP
2009-05-06 08:50:35
date last changed
2017-01-01 07:32:19
@article{b0c70c18-40e9-4c18-86dd-9b141fe903c0,
  abstract     = {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.},
  author       = {Thorsson, Ola and Bjuväng, Agneta and Granerus, Göran},
  issn         = {1473-5628},
  language     = {eng},
  pages        = {449--454},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Nuclear Medicine Communications},
  title        = {Advantages of standardized criteria for the interpretation of angiotensin-converting enzyme inhibition renography.},
  url          = {http://dx.doi.org/10.1097/MNM.0b013e328329fdd7},
  volume       = {30},
  year         = {2009},
}