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Nephrology Dialysis Transplantation, Vol 13, Issue 7 1690-1695, Copyright © 1998 by Oxford University Press

ORIGINAL ARTICLES

Intravascular ultrasound imaging of atherosclerotic renal arteries: comparison between in vitro and in vivo studies

G Yasuda, T Takizawa, I Takasaki, H Shionoiri, S Umemura and K Shimoyama
Second Department of Internal Medicine, and Department of Pathology, Yokohama City University, School of Medicine, 3-46 Urafune, Minami-ku, Yokohama, 232 Japan; Corresponding author

Background: Intravascular ultrasound (IVUS) imaging, a new modality, may be feasible and useful for the assessment of atherosclerotic renal arteries. However, comparison between in vivo and in vitro studies to confirm pathological changes corresponding with IVUS findings obtained from renal arteries was not fully evaluated. Methods: We evaluated ultrasound images of 18 post-mortem human renal arteries and cross-sectional IVUS images of main renal arteries in five patients with renal artery stenosis (RAS) or essential hypertension. Results: In vitro studies have shown that renal-artery images had three layers when the arteries had fibrous intimal thickening and medial hypertrophy. Renal arteries, in which the fibrous intima was not well developed, showed circumferentially homogenous bright echoes. In patients with atherosclerotic RAS and essential hypertension, IVUS images showed hyperechoic areas in the renal arterial walls, probably due to atherosclerosis. Typical three-layered ultrasound appearance was not easily seen during in vivo studies. Conclusion: Our findings suggest that hyperechoic images can be a diagnostic clue of atherosclerosis. However, in vitro results do not always correspond exactly to in vivo findings, and caution is needed when findings from in vitro IVUS imaging studies are applied to in vivo studies. Key words: angiography; angioplasty; atherosclerosis fibromuscular dysplasia renovascular hypertension
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