The role of angiography as a diagnostic tool continues to di-minish with the increasing accuracy of noninvasive tech-niques to evaluate the vascular system. The renal arteriogram is performed after puncture of a more peripheral vessel such as the common femoral artery, with advancement of a catheter into the renal artery origin. Contrast material is in-jected via the catheter and rapid, typically digital, conventional radiographic images are obtained. The renal arterial vessels are well demonstrated, along with nephrographic images of the kidney and views of the venous drainage (Figure 9-15). Delayed images may be obtained to demonstrate the renal col-lecting system. The angiogram plays little role in diagnostic evaluation of the renal parenchyma, having been supplanted by cross-sectional imaging techniques. However, the still supe-rior spatial resolution of angiography permits detailed evalua-tion of the renal arterial supply and has a small but important diagnostic role in evaluating the small vessels of the kidney for such diseases as vasculitis and fibromuscular dysplasia. Themain role for angiography today, as discussed later, is aiding and guiding interventional, therapeutic techniques.
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