Renal artery stenosis: comparative assessment by unenhanced renal artery mra versus contrast-enhanced MRA
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Michael M. Y. Khoo & Dhafer Deeab & Wladyslaw M. W. Gedroyc & Neil Duncan & David Taube & Elizabeth A. Dick
- چاپ و سال / کشور: 2011
Description
Objectives To evaluate steady-state free precession (SSFP) non-contrast-enhanced MR angiography (Unenhanced-MRA) versus conventional contrast-enhanced MR angiography (CE-MRA) in the detection of renal artery stenosis (RAS). Methods Retrospective analysis of 70 consecutive patients referred for suspected RAS, examined by SSFP Unenhanced-MRA and CE-MRA. Image quality, quality of visible renal arterial segments, presence and grade of RAS were evaluated. The Unenhanced-MRA were compared against reference standard CE-MRA results. Results 149 renal arteries were assessed with 21 haemodynamically significant stenoses (.50% stenosis) demonstrated by CE-MRA. Combined sensitivity and specificity for RAS detection by Unenhanced-MRA was 72.8% and 97.8% respectively. There is substantial correlation for RAS detection between Unenhanced-MRA and CE-MRA with kappa values of between 0.64 and 0.74. There was excellent interobserver correlation for RAS on Unenhanced-MRA (kappa values 0.82.1.0). Conclusions Our study has shown Unenhanced-MRA to be a viable alternative to CE-MRA, yielding images equal in quality without the requirement for gadolinium contrast agents. The sensitivity and specificity for the detection of haemodynamically significant stenoses are comparable to CE-MRA. Potentially, Unenhanced-MRA could be used as an initial investigation to avoid performing CE-MRA in patients with normal renal arteries, however we suggest that its real value will lie in being complementary to CE-MRA.
Eur Radiol (2011) 21:1470–1476 DOI 10.1007/s00330-011-2086-6 Received: 25 August 2010 / Revised: 1 December 2010 / Accepted: 3 January 2011 / Published online: 20 February 2011
