Fibromuscular Dysplasia FMD

The second most common cause of renal artery stenosis is fibromuscular dysplasia (FMD). FMD affects younger patients and women more frequently than men. One study reports FMD in as many as 10% of cases of renal artery stenosis [16] but our observation is that it is rare, which may reflect our older patient population. Patients with pure renin-dependent (renovascular) hypertension are common with renal FMD and may be cured with angioplasty in over 80% of cases. In contrast to atherosclerotic stenoses, FMD tends to affect the mid- and distal renal artery (Fig. 9). Initial medical therapy for renovascular hypertension associated with FMD is an ACE inhibitor. Early detection and intervention are recommended for FMD because it responds well to balloon angio-plasty and procedural morbidity is low in these typically younger patients. Three-dimensional CE MRA permits visualization of renal artery pathology affecting both the proximal as well as the distal renal arteries if spatial resolution is sufficient. In our experience, fMd is always well seen on 3D phase contrast MRA as a signal void from turbulent dephasing caused by the multiple webs (Fig. 10a-c). However, intrarenal segmental renal arteries may be missed on renal 3D CE MRA due to motion of the kidneys, parenchymal enhancement and limited spatial resolution.

Phase Contrast MraScan And Renal Fmd
Fig. 9. High resolution CE MRA (Gd-BOPTA, 0.1 mmol/kg) in a patient with fibromuscular dysplasia (FMD). Note the multiple irregular dilatations and stenoses of the renal arteries (arrows) [Images courtesy of Dr. G. Schneider]

Fig. 10a-c. Renal MRA with single dose Gd-BOPTA (0.1 mmol/kg) shows fibromuscular dysplasia (FMD) of both renal arteries b

Fig. 11a, b. CE MRA in a patient with Kawasaki's disease in childhood. CE MRA shows a persistent distal right renal artery aneurysm

Fmd Renal Artery Mra

Fig. 11a, b. CE MRA in a patient with Kawasaki's disease in childhood. CE MRA shows a persistent distal right renal artery aneurysm

Was this article helpful?

0 0
Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

Get My Free Ebook


Post a comment