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Non-contrast MR angiography versus contrast enhanced MR angiography for detection of renal artery stenosis: a comparative analysis in 400 renal arteries

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

In this study, we compared non-contrast MR angiography (NC-MRA) with conventional 3D contrast-enhanced MRA (CE-MRA) in patients suspected to have renal artery stenosis (RAS).

Methods

From March 2014 to March 2020, patients who were evaluated for RAS and had a glomerular filtration rate > 30 ml/min/1.73 m2 underwent MR imaging on a 3T MR Scanner (Signa Hdxt General Electrics, Milwaukee, USA) using a Torso PA coil. The NC-MRA sequence was performed using a 3D fat-suppressed inflow inversion recovery balanced steady state free precession (SSFP) sequence (Inhance 3D Inflow IR, GE Medical) whereas the CE-MRA sequence was a 3D fast spoiled gradient echo (FSPGR). Overall quality of images was rated 1 to 4. Stenosis was reported as grade 1 (Normal), 2 (< 50% narrowing), 3 (> 50% narrowing) and 4 (Total occlusion). Grade 3 and 4 were considered haemodynamically significant.

Results

During the study period, 201 patients were enrolled (400 renal arteries). For hemodynamically significant (grade 3/4) stenosis, NC-MRA correctly diagnosed 72 patients (95 arteries) while in 2 patients (2 arteries), NC-MRA underdiagnosed the stenosis as grade 2 (these were found to have grade 3 stenosis on CE-MRA). The kappa value of agreement between NC-MRA and CE-MRA for detection of RAS showing excellent agreement (p < 0.001).

Conclusion

In one of the largest series of patients so far, we found that NC-MRA is a viable alternative to CE-MRA for detection of RAS, highly correlating with CE-MRA for grade of stenosis and with additional advantage of lack of gadolinium based contrast agents toxicity.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raibareli Road, Lucknow, Uttar Pradesh, 226014, India

    Hira Lal, Rani Kunti Randhir Singh, Ankusha Yadav & Anuradha Singh

  2. Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raibareli Road, Lucknow, 226014, India

    Priyank Yadav

  3. Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raibareli Road, Lucknow, 226014, India

    Dharmendra Bhadauria

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  1. Hira Lal
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  2. Rani Kunti Randhir Singh
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  5. Dharmendra Bhadauria
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Correspondence to Anuradha Singh.

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Lal, H., Singh, R.K.R., Yadav, P. et al. Non-contrast MR angiography versus contrast enhanced MR angiography for detection of renal artery stenosis: a comparative analysis in 400 renal arteries. Abdom Radiol 46, 2064–2071 (2021). https://doi.org/10.1007/s00261-020-02836-5

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  • DOI: https://doi.org/10.1007/s00261-020-02836-5

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