Characterized by segmental areas of collagen deposition and smooth muscle overgrowth
Affects multiple arterial territories
Renal artery: Most commonly involved
Carotid artery: 2nd most commonly involved
May cause stenosis, dissection, aneurysms
Known cause of renovascular hypertension
Classified based on involved layer of arterial wall
Intimal fibroplasia (< 10%)
Focal concentric or long-segment tubular stenosis
Internal elastic lamina may be disrupted
Medial fibroplasia (3 subtypes)
Medial dysplasia (80%): Multiple stenoses and aneurysms involving mid to distal renal artery; causes classic string of beads appearance
Perimedial fibroplasia (10-15%): May also cause string of beads appearance; beads have smaller diameter than parent vessel
Medial hyperplasia (1-2%): Smooth stenosis
Adventitial fibroplasia (< 1%)
Similar appearance to intimal fibroplasia
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Baumgartner I et al: Renovascular hypertension: screening and modern management. Eur Heart J. 32(13):1590-8, 2011
Olin JW et al: Diagnosis, management, and future developments of fibromuscular dysplasia. J Vasc Surg. 53(3):826-36, 2011
Blondin D et al: Fibromuscular dysplasia in living renal donors: still a challenge to computed tomographic angiography. Eur J Radiol. 75(1):67-71, 2010
Liu PS et al: CT angiography of the renal circulation. Radiol Clin North Am. 48(2):347-65, viii-ix, 2010
Slovut DP et al: Fibromuscular dysplasia. N Engl J Med. 350(18):1862-71, 2004
Characterized by segmental areas of collagen deposition and smooth muscle overgrowth
Affects multiple arterial territories
Renal artery: Most commonly involved
Carotid artery: 2nd most commonly involved
May cause stenosis, dissection, aneurysms
Known cause of renovascular hypertension
Classified based on involved layer of arterial wall
Intimal fibroplasia (< 10%)
Focal concentric or long-segment tubular stenosis
Internal elastic lamina may be disrupted
Medial fibroplasia (3 subtypes)
Medial dysplasia (80%): Multiple stenoses and aneurysms involving mid to distal renal artery; causes classic string of beads appearance
Perimedial fibroplasia (10-15%): May also cause string of beads appearance; beads have smaller diameter than parent vessel
Medial hyperplasia (1-2%): Smooth stenosis
Adventitial fibroplasia (< 1%)
Similar appearance to intimal fibroplasia
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Baumgartner I et al: Renovascular hypertension: screening and modern management. Eur Heart J. 32(13):1590-8, 2011
Olin JW et al: Diagnosis, management, and future developments of fibromuscular dysplasia. J Vasc Surg. 53(3):826-36, 2011
Blondin D et al: Fibromuscular dysplasia in living renal donors: still a challenge to computed tomographic angiography. Eur J Radiol. 75(1):67-71, 2010
Liu PS et al: CT angiography of the renal circulation. Radiol Clin North Am. 48(2):347-65, viii-ix, 2010
Slovut DP et al: Fibromuscular dysplasia. N Engl J Med. 350(18):1862-71, 2004
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