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3D FIESTA pulse sequence for assessing renal artery stenosis: is it a reliable application in unenhanced magnetic resonance angiography?

  • Magnetic Resonance
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Abstract

Objectives

To assess the capability of the three-dimensional (3D) Fast Imaging Employing Steady-State Acquisition (FIESTA) sequence in evaluating renal artery stenosis (RAS).

Methods

We retrospectively analysed 79 patients referred for suspected RAS, examined by 3D FIESTA and contrast-enhanced magnetic resonance angiography (CE-MRA), using a 1.5T whole-body scanner. Image quality was assessed as well as the presence and grade of RAS. Patients with RAS ≥ 50 % were evaluated for possible digital subtraction angiography (DSA). Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of 3D FIESTA were calculated with ROC analysis using CE-MRA and DSA as the standard of reference.

Results

A total of 186 renal arteries were assessed; 36 had RAS ≥ 50 % demonstrated by CE-MRA. Ten patients underwent DSA, for a total evaluation of 22 arteries. Sensitivity, specificity, NPV, PPV, and accuracy of 3D FIESTA were 91.7 %, 100 %, 98 %, 100 %, and 98 %, respectively, as compared to CE-MRA, and 88.2 %, 100 %, 71.4 %, 100 %, and 91 %, respectively, as compared to DSA. The area under the ROC curve (AUC) of 3D FIESTA as compared to CE-MRA and DSA was 0.958 and 0.941, respectively.

Conclusions

Our study demonstrated the capability of the 3D FIESTA sequence in evaluating RAS, with high-quality images and good diagnostic accuracy.

Key Points

The 3D FIESTA sequence provides a robust evaluation of RAS.

The 3D FIESTA sequence allows non-invasive evaluation of the renal arteries.

The 3D FIESTA sequence could be a useful tool in evaluating RAS.

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Acknowledgements

The scientific guarantor of this publication is Rita Golfieri. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, observational, performed at one institution.

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Correspondence to Caterina Gaudiano.

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Gaudiano, C., Busato, F., Ferramosca, E. et al. 3D FIESTA pulse sequence for assessing renal artery stenosis: is it a reliable application in unenhanced magnetic resonance angiography?. Eur Radiol 24, 3042–3050 (2014). https://doi.org/10.1007/s00330-014-3330-7

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  • DOI: https://doi.org/10.1007/s00330-014-3330-7

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