MR angiography in the evaluation of a renovascular cause of neonatal hypertension

Neonatal hypertension occurs in 2% of all infants and it is caused by renovascular abnormalities in 70% of these infants. The gold standard for diagnosing renovascular disease is conventional renal angiography. However, in neonates the procedure is not commonly used because of its invasive and technically challenging nature. MRI and MR angiography (MRA) are less invasive yet reliable means of detecting renovascular disease in adults. There is minimal literature on the use of MRI/MRA in neonatal hypertension. We report a neonate with hypertension secondary to a renovascular abnormality in which MRI/MRA was helpful in uncovering segmental renal artery stenosis. The infant underwent partial nephrectomy with subsequent resolution of his hypertension. Further studies are needed to validate the use of MRI/MRA in the evaluation of neonatal hypertension.