Adult; Aged; Aged, 80 and over; Contrast Media; Feasibility Studies; Female; Gadolinium DTPA/diagnostic use; Humans; Hypertension, Renovascular/diagnosis; Image Enhancement/methods; Magnetic Resonance Angiography/methods; Male; Middle Aged; Renal Artery/pathology; Reproducibility of Results; Respiratory Mechanics; Sensitivity and Specificity
Abstract :
[en] OBJECTIVE: The purpose of this study was to assess the feasibility and accuracy of accelerated free-breathing and breath-hold gadolinium-enhanced MR angiography of the main renal arteries compared with digital subtraction angiography. MATERIALS AND METHODS: Renal MR angiograms and catheter angiograms of 47 patients (19 men, 28 women; mean age, 68.1 +/- 15.1 years; range, 28-86 years) were reviewed. Thirty-one of the patients underwent free-breathing and 16 underwent breath-hold MR angiography with the same accelerated multiphase imaging protocol. Images were analyzed for examination quality, percentage narrowing of the main renal artery, and visibility of the branches. Diagnostic values of MR angiography were calculated with catheter angiography as the standard of reference. RESULTS: Sixty-five arteries, 24 of which (37%) had > 49% narrowing, were evaluated in the free-breathing group, and 37 arteries, six of which (16%) had > 49% narrowing, were evaluated in the breath-hold group. Comparison with digital subtraction angiography showed 100% (24/24) sensitivity and 95% (39/41) specificity for > 49% renal artery stenosis and 88% sensitivity (15/17) and 100% (48/48) specificity for > 74% renal artery stenosis in the free-breathing group. In the breath-hold group, sensitivity was 100% (6/6) and specificity 97% (30/31) for > 49% renal artery stenosis, and sensitivity was 100% (5/5) and specificity 100% (32/32) for > 74% renal artery stenosis. None of the examinations was nondiagnostic for the main renal arteries, but a smaller number of visible arterial tree subdivisions were found in the free-breathing group (average, 3.64 per patient) than in the breath-hold group (average, 5.87 per patient) (p = 0.035). CONCLUSION: Like breath-hold examinations, accelerated free-breathing MR angiographic examinations are feasible and accurate in evaluation of the main renal arteries.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
NCHIMI LONGANG, Alain ; Centre Hospitalier Universitaire de Liège - CHU > Radiodiagnostic
Brisbois, Denis
Materne, Roland
Broussaud, Thomas K. Y.
Mancini, Isabelle
Magotteaux, Paul
Language :
English
Title :
Free-breathing accelerated gadolinium-enhanced MR Angiography in the Diagnosis of Renovascular Disease.
Publication date :
2009
Journal title :
American Journal of Roentgenology
ISSN :
0361-803X
eISSN :
1546-3141
Publisher :
American Roentgen Ray Society, United States - Virginia
Tan, K.T., Van Beek, E.J.R., Brown, P.W.G., Van Delden, O.M., Tijssen, J., Ramsay, L.E., Magnetic resonance angiography for the diagnosis of renal artery stenosis: A meta-analysis (2002) Clinical Radiology, 57 (7), pp. 617-624. , DOI 10.1053/crad.2002.0941
Vasbinder, G.B.C., Nelemans, P.J., Kessels, A.G.H., Kroon, A.A., De Leeuw, P.W., Van Engelshoven, J.M.A., Diagnostic tests for renal artery stenosis in patients suspected of having renovascular hypertension: A meta-analysis (2001) Annals of Internal Medicine, 135 (6), pp. 401-411
Masunaga, H., Takehara, Y., Isoda, H., Igarashi, T., Sugiyama, M., Isogai, S., Kodaira, N., Sakahara, H., Assessment of gadolinium-enhanced time-resolved three-dimensional MR angiography for evaluating renal artery stenosis (2001) American Journal of Roentgenology, 176 (5), pp. 1213-1219
Van Lieven, H., De Jaegere, T., Bosnians, H., Stockx, L., Vanbeckevoort, D., Oyen, R., Fagard, R., Marchal, G., Breath-hold contrast-enhanced three-dimensional MR angiography of the abdomen: Time-resolved imaging versus single-phase imaging (2000) Radiology, 214 (1), pp. 149-156
Schoenberg, S.O., Rieger, J., Nittka, M., Dietrich, O., Johannson, L.O., Reiser, M.F., Renal MR angiography: Current debates and developments in imaging of renal artery stenosis (2003) Seminars in Ultrasound, CT and MRI, 24 (4), pp. 255-267. , DOI 10.1016/S0887-2171(03)90015-1
Griswold, M.A., Jakob, P.M., Heidemann, R.M., Nittka, M., Jellus, V., Wang, J., Kiefer, B., Haase, A., Generalized Autocalibrating Partially Parallel Acquisitions (GRAPPA) (2002) Magnetic Resonance in Medicine, 47 (6), pp. 1202-1210. , DOI 10.1002/mrm.10171
Schoenberg, S.O., Rieger, J., Weber, C.H., Michaely, H.J., Waggershauser, T., Ittrich, C., Dietrich, O., Reiser, M.F., High-spatial-resolution MR angiography of renal arteries with integrated parallel acquisitions: Comparison with digital subtraction angiography and US (2005) Radiology, 235 (2), pp. 687-698. , DOI 10.1148/radiol.2352031693
Kramer, U., Wiskirchen, J., Fenchel, M.C., Isotropic high-spatial-resolution contrast-enhanced 3.0-T MR angiography in patients suspected of having renal artery stenosis (2008) Radiology, 247, pp. 228-240
Maki, J.H., Chenevert, T.L., Prince, M.R., The effects of incomplete breath-holding on 3D MR image quality (1997) Journal of Magnetic Resonance Imaging, 7 (6), pp. 1132-1139. , DOI 10.1002/jmri.1880070628
Kalra, P.A., Guo, H., Kausz, A.T., Gilbertson, D.T., Liu, J., Chen, S.-C., Ishani, A., Foley, R.N., Atherosclerotic renovascular disease in United States patients aged 67 years or older: Risk factors, revascularization, and prognosis (2005) Kidney International, 68 (1), pp. 293-301. , DOI 10.1111/j.1523-1755.2005.00406.x, PII 4494588
Weiger, M., Pruessmann, K.P., Kassner, A., Roditi, G., Lawton, T., Reid, A., Boesiger, P., Contrast-enhanced 3D MRA using SENSE (2000) Journal of Magnetic Resonance Imaging, 12 (5), pp. 671-677. , DOI 10.1002/1522-2586(200011)12:5<671::AID-JMRI3>3.0.CO
2-F
Volk, M., Strotzer, M., Lenhart, M., Seitz, J., Manke, C., Feuerbach, S., Link, J., Renal time-resolved MR angiography: Quantitative comparison of gadobenate dimeglumine and gadopentetate dimeglumine with different doses (2001) Radiology, 220 (2), pp. 484-488
Barger, A.V., Block, W.F., Toropov, Y., Grist, T.M., Mistretta, C.A., Time-resolved contrast-enhanced imaging with isotropic resolution and broad coverage using an undersampled 3D projection trajectory (2002) Magnetic Resonance in Medicine, 48 (2), pp. 297-305. , DOI 10.1002/mrm.10212
Draney, M.T., Zarins, C.K., Taylor, C.A., Three-dimensional analysis of renal artery bending motion during respiration (2005) Journal of Endovascular Therapy, 12 (3), pp. 380-386. , DOI 10.1583/05-1530.1
Zhang, H., Prince, M.R., Renal MR angiography (2004) Magnetic Resonance Imaging Clinics of North America, 12 (3), pp. 487-503. , DOI 10.1016/j.mric.2004.03.002, PII S1064968904000376
Michaely, H.J., Sourbron, S., Dietrich, O., Attenberger, U., Reiser, M.F., Schoenberg, S.O., Functional renal MR imaging: An overview (2007) Abdominal Imaging, 32 (6), pp. 758-771. , DOI 10.1007/s00261-006-9150-8
Katoh, M., Buecker, A., Stuber, M., Gunther, R.W., Spuentrup, E., Free-breathing renal MR angiography with steady-state free-precession (SSFP) and slab-selective spin inversion: Initial results (2004) Kidney International, 66 (3), pp. 1272-1278. , DOI 10.1111/j.1523-1755.2004.00882.x
Weiss, A.S., Lucia, M.S., Teitelbaum, I., A case of nephrogenic fibrosing dermopathy/nephrogenic systemic fibrosis (2007) Nature Clinical Practice Nephrology, 3 (2), pp. 111-115. , DOI 10.1038/ncpneph0373, PII NCPNEPH0373
Soulez, G., Pasowicz, M., Benea, G., Renal artery stenosis evaluation: Diagnostic performance of gadobenate dimeglumine-enhanced MR angiography- comparison with DSA (2008) Radiology, 247, pp. 273-285
Sutter, R., Nanz, D., Lutz, A.M., Pfammatter, T., Seifert, B., Struwe, A., Heilmaier, C., Willmann, J.K., Assessment of aortoiliac and renal arteries: MR angiography with parallel acquisition versus conventional MR angiography and digital subtraction angiography (2007) Radiology, 245 (1), pp. 276-284. , DOI 10.1148/radiol.2451062081
Cheung, C.M., Hegarty, J., Kalra, P.A., Dilemmas in the management of renal artery stenosis (2005) British Medical Bulletin, 73-74, pp. 35-55. , DOI 10.1093/bmb/ldh049
Vasbinder, G.B.C., Maki, J.H., Nijenhuis, R.J., Leiner, T., Wilson, G.J., Kessels, A.G.H., Lemarie, E.E.L.E., Van Engelshoven, J.M.A., Motion of the distal renal artery during three-dimensional contrast-enhanced breath-hold MRA (2002) Journal of Magnetic Resonance Imaging, 16 (6), pp. 685-696. , DOI 10.1002/jmri.10214
