Renal Artery Stenosis: CT Angiography—Comparison of Real-time Volume-rendering and Maximum Intensity Projection Algorithms

PURPOSE: To compare results of helical computed tomographic (CT) angiography with real-time interactive volume rendering (VR) to CT angiography with maximum intensity projection (MIP) for the detection of renal artery stenosis. MATERIALS AND METHODS: Twenty-five patients underwent both conventional and CT angiography of the renal arteries. Images were blindly reviewed after rendering with MIP and VR algorithms. MIP images were viewed in conjunction with axial CT images; VR models were evaluated in real time at the workstation without CT images. Findings in 50 main and 11 accessory renal arteries were categorized as normal or by degree of stenosis. RESULTS: All arteries depicted on conventional angiograms were visualized on MIP and VR images. Receiver operating characteristic (ROC) analysis for MIP and VIR images demonstrated excellent discrimination for the diagnosis of stenosis of at least 50% (area under the ROC curve, 0.96–0.99). Although sensitivity was not significantly different for VR and MIP (89% ...