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Erschienen in:
17.08.2020 | Classics in Abdominal Radiology
Bilateral renal artery parvus tardus: a sign of aortic coarctation in pediatric patients
Erschienen in: Abdominal Radiology | Ausgabe 2/2021
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Bilateral renal artery parvus tardus (BRAPT) Doppler waveform is an uncommon finding in the workup of renovascular hypertension. The etiology of this finding can often be suggested based on the patient’s age and gender. In younger patients (< 18 years old), BRAPT can be a sign of an underlying aortic abnormality, which in the present case proved to be aortic coarctation (Figs. 1 and 2). Other aortic conditions may also present in this manner and in the pediatric population including the following: neurofibromatosis, midaortic syndrome, and vasculitis (Takayasu) [1‐3]. Fibromuscular dysplasia (FMD) is a non-inflammatory vasculopathy that is the most common cause of renal artery stenosis (RAS) in children [4]. FMD typically involves the bilateral mid- to distal renal arteries resulting in arterial stenoses, aneurysms, and potentially dissections.
Fig. 1
17-year-old male patient with hypertension. Bilateral renal artery spectral Doppler US images of the proximal renal arteries demonstrate slow arterial peak upstroke (arrows) and diminished amplitude (arrowheads) consistent with parvus tardus. These features were also demonstrated in the remaining biltaeral renal artery segments, which are not shown. Right renal artery (a) and left renal artery (b)
Fig. 2
Follow-up contrast-enhanced computed tomography aortic angiogram 3D reformat demonstrating post-ductal aortic coarctation (a, arrow), as well as collateralization between dilated internal thoracic arteries (b, curved arrows) and inferior epigastric arteries (b, arrowheads)
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