Abstract
During the past decade, noninvasive CTA and MRA imaging techniques have replaced catheter angiography for evaluation of the renal arteries. This article reviews techniques for optimizing renal MRA and CTA, assesses the advantages and limitations of MRA and CTA, and provides the current indications for renal vascular imaging including renal artery stenosis screening. New and future developments in these rapidly evolving techniques are also discussed.
Similar content being viewed by others
References
Galanski M, Prokop M, Chavan A, et al. (1994) Accuracy of CT angiography in the diagnosis of renal artery stenosis. Rofo 161(6):519–525
Fleischmann D (2003) Multiple detector-row CT angiography of the renal and mesenteric vessels. Eur J Radiol 45(suppl 1):S79–S87
Prince MR, Yucel EK, Kaufman JA, et al. (1993) Dynamic gadolinium-enhanced three-dimensional abdominal MR arteriography. J Magn Reson Imaging 3:877–881
Prince MR, Narasimham DL, Stanley JC, et al. (1995) Breath-hold gadolinium-enhanced MR angiography of the abdominal aorta and its major branches. Radiology 197:785–892
Maki JH, Prince MR, Chenevert TC (1998) Optimizing three-dimensional gadolinium-enhanced magnetic resonance angiography. Invest Radiol 33(9):528–537
Mittal TK, Evans C, Perkins T, et al. (2001) Renal arteriography using gadolinium enhanced 3D MR angiography—clinical experience with the technique, its limitations and pitfalls. Br J Radiol 74:495–502
Shetty AN, Bis KG, Kirsch M, et al. (2000) Contrast-enhanced breath-hold three-dimensional magnetic resonance angiography in the evaluation of renal arteries: optimization of technique and pitfalls. J Magn Reson Imaging 12:912–923
Fain SB, King BF, Breen JF, et al. (2001) High spatial resolution contrast-enhanced MR angiography of the renal arteries: a prospective comparison with digital subtraction angiography. Radiology 218:481–490
Qanadli SD, Soulez G, Therasse E, et al. (2001) Detection of renal artery stenosis: prospective comparison of captopril-enhanced Doppler sonography, captopril-enhanced scintigraphy, and MR angiography. AJR 177:1123–1129
Thornton J, O’Callaghan J, Walshe J, et al. (1999) Comparison of digital subtraction angiography with gadolinium-enhanced magnetic resonance angiography in the diagnosis of renal artery stenosis. Eur Radiol 9:930–934
Leung DA, Hagspiel KD, Angle F, et al. (2002) MR angiography of the renal arteries. Radiol Clin N Am 40:847–865
Olin JW, Melia M, Young JR, et al. (1990) Prevalence of atherosclerotic renal artery stenosis in patients with atherosclerosis elsewhere. Am J Med 88:46N–51N
Jean WJ, al Bitar I, Zwicke DL, et al. (1994) High incidence of renal artery stenosis in patients with coronary artery disease. Cathet Cardiovasc Diagn 32:8–10
Scoble JE, Maher ER, Hamilton G, et al. (1989) Atherosclerotic renovascular disease causing renal impairment: a case for treatment. Clin Nephrol 31:119–122
van Jaarsveld BC, Krijnen P, Pieterman H, et al. (2000) The effect of balloon angioplasty on hypertension in atherosclerotic renal artery stenosis: Dutch renal artery stenosis intervention cooperative study group. N Engl J Med 342:1007–1014
Webster J, Marshall F, Abdalla M, et al. (1998) Randomised comparison of percutaneous angioplasty vs. continued medical therapy for hypertensive patients with atheromatous renal artery stenosis. Scottish and Newcastle renal artery stenosis collaborative group. J Hum Hypertens 12:329–335
Dorros G, Jaff M, Mathiak L, et al. (2002) Multicenter Palmaz stent renal artery stenosis revascularization registry report: four-year follow-up of 1,058 successful patients. Catheter Cardiovasc Interv 2:182–188
Isles CG, Robertson S, Hill D (1999) Management of renovascular disease: a review of renal artery stenting in ten studies. QJM 92:159–167
Beutler JJ, van Ampting JMA, van de Ven PJG, et al. (2001) Long-term effects of arterial stenting on kidney function for patients with ostial atherosclerotic renal artery stenosis and renal insufficiency. J Am Soc Nephrol 12:1475–1481
Uder M, Humke U (2005) Endovascular therapy of renal artery stenosis: where do we stand today? Cardiovasc Intervent Radiol 28:139–147
Bettmann MA, Dake MD, Hopkins N, et al. (2004) Atherosclerotic vascular disease conference writing group VI: revascularization. Circulation 109:2643–2650
Haller C (2002) Atherosclerotic renal artery stenosis: conservative versus interventional management. Heart 88:193–197
Tan KT, Van Beek EJR, Brown PWG, et al. (2002) Magnetic resonance angiography for the diagnosis of renal artery stenosis: a meta-analysis. Clin Radiol 57:617–624
Boudewijn G, Vasbinder C, Nelemans PJ, et al. (2001) Diagnostic tests for renal artery stenosis in patients suspected of having renovascular hypertension: a meta-analysis. Ann Intern Med 135:401–411
Boudewijn G, Vasbinder C, Nelemans PJ, et al. (2004) Accuracy of computed tomographic angiography and magnetic resonance angiography for diagnosing renal artery stenosis. Ann Intern Med 141:674–682
Schoenberg SO, Rieger J, Weber CH, et al. (2005) High spatial resolution MR angiography of renal arteries with integrated parallel acquisitions: comparison with digital subtraction angiography and US. Radiology 235:687–698
Kramer U, Kambiz N, Laub G, et al. (2006) High-resolution magnetic resonance angiography of the renal arteries using parallel imaging acquisition techniques at 3.0 T. Invest Radiol 41:125–132
Draney MT, Zarins CK, Taylor CA (2005) Three-dimensional analysis of renal artery bending motion during respiration. J Endovasc Ther 12:380–386
Boudewijn G, Vasbinder C, Maki JH, et al. (2002) Motion of the distal renal artery during three-dimensional contrast-enhanced breath-hold MRA. J Magn Reson Imaging 16:685–696
Masunaga H, Takehara Y, Isoda H, et al. (2001) Assessment of gadolinium-enhanced time-resolved three-dimensional MR angiography for evaluating renal artery stenosis. AJR 176:1213–1219
Volk M, Strotzer M, Lenhart M, et al. (2000) Time-resolved contrast-enhanced MR angiography of renal artery stenosis: diagnostic accuracy and interobserver variability. AJR 174:1583–1588
Buecker A, Spuentrup E, Ruebben A, et al. (2002) Artifact-free in-stent lumen visualization by standard magnetic resonance angiography using a new metallic magnetic resonance imaging stent. Circulation 105(15):1772–1775
van Holten J, Wielopolski P, Bruck E, et al. (2003) High flip angle imaging of metallic stents: implications for MR angiography and intraluminal signal interruption. Magn Reson Med 50(4):879–883
Spuentrup E, Ruebben A, Stuber M, et al. (2003) Metallic renal artery MR imaging stent: artifact-free lumen visualization with projection and standard renal MR angiography. Radiology 227(3):897–902
Kearney GP, Waters WB, Klein LA, et al. (1981) Results of inferior vena cava resection for renal cell carcinoma. J Urol 125:769
Hallscheidt PJ, Fink C, Haferkamp A, et al. (2005) Preoperative staging of renal cell carcinoma with inferior vena cava thrombus using multidetector CT and MRI: prospective study with histopathological correlation. J Comput Assist Tomogr 29:64–68
Kallmann DA, King BF, Hattery RR, et al. (1992) Renal vein and inferior vena cava tumor thrombus in renal cell carcinoma: CT, US, MRI, and vena cavography. J Comput Assist Tomogr 16:240–247
Choyke PL, Wather MCM, Wagner JR, et al. (1997) Renal cancer: preoperative evaluation with dual phase three dimensional MR angiography. Radiology 205:767–771
Oto A, Herts BR, Remer EM, et al. (1998) Inferior vena cava tumor thrombus in renal cell carcionoma: staging by MR imaging and impact on surgical treatment. AJR 171:1619–1624
Schaffer D, Sahyoun AI, Madras PN, et al. (1998) Two hundred and one consecutive living-donor nephrectomies. Arch Surg 133:426–431
Lind MY, Ijzermans JNM, Bonjer HJ (2002) Open vs. laparoscopic donor nephrectomy in renal transplantation. BJU Int 89:162–168
Hussain SM, Kock MCJM, Ijzermans JNM, et al. (2003) MR imaging: a one stop shop modality for preoperative evaluation of potential living kidney donors. Radiographics 23:505–520
Fink C, Hallscheidt PJ, Hosch WP, et al. (2003) Preoperative evaluation of living renal donors: value of contrast-enhanced 3D magnetic resonance angiography and comparison of three rendering algorithms. Eur Radiol 13:794–801
Subramaniam M, Mizzi A, Roditi G (2004) Magnetic resonance angiography in potential live renal donors: a joint radiological and surgical evaluation. Clin Radiol 59:335–341
Rajab A, Khabiri H, Pelletier RP, et al. (2004) Magnetic resonance angiography for preoperative evaluation of potential kidney donors. J Surg Res 120:195–200
Tan SP, Bux SI, Kumar G, et al. (2004) Evaluation of live renal donors with three-dimensional contrast-enhanced magnetic resonance angiography in comparison to catheter angiography. Transplant Proc 36:1914–1916
Al-Saeed O, Ismail M, Sheikh M, et al. (2005) Contrast-enhanced three-dimensional fast spoiled gradient magnetic resonance angiography of the renal arteries for potential living renal transplant donors: a comparative study with digital subtraction angiography. Australas Radiol 49:214–217
Bhatti AA, Chugtai A, Haslam P, et al. (2005) Prospective study comparing three-dimensional computed tomography and magnetic resonance imaging for evaluating renal vascular anatomy in potential living renal donors. BJU Int 96:1105–1108
Wang DS, Stolpen AH, Bird VG, et al. (2005) Correlation of preoperative three-dimensional magnetic resonance angiography with intraoperative findings in laparoscopic renal surgery. J Endocr 19:193–199
Di Felice A, Inguaggiato P, Rubbiani E, et al. (2002) Magnetic resonance in renal transplantation: evaluation of post-surgery complications. Transplant Proc 34:3193–3195
Browne RFJ, Riordan EO, Roberts JA, et al. (2004) Renal artery aneurysms: diagnosis and surveillance with 3D contrast-enhanced magnetic resonance angiography. Eur Radiol 14:1807–1812
Svensson J, Petersson JS, Stahlberg F, et al. (1999) Image artifacts due to a time-varying contrast medium concentration in 3D contrast-enhanced MRA. J Magn Reson Imaging 10(6):919–928
Lee VS, Martin DJ, Krinsky GA, et al. (2000) Gadolinium-enhanced MR angiography: artifacts and pitfalls. AJR 175:197–205
Zhang HL, Schoenberg SO, Resnick LM, et al. (2003) Diagnosis of renal artery stenosis: combining gadolinium-enhanced three-dimensional magnetic resonance angiography with functional magnetic resonance pulse sequences. AJH 16:1079–1082
Hood MN, Ho VB, Corse WR (2002) Three-dimensional phase-contrast magnetic resonance angiography: a useful clinical adjunct to gadolinium-enhanced three-dimensional renal magnetic resonance angiography? Mil Med 167:343–349
Miller S, Schick F, Duda SH, et al. (1998) Gd-enhanced 3D phase-contrast MR angiography and dynamic perfusion imaging in the diagnosis of renal artery stenosis. Magn Reson Imaging 16:1005–1012
Schoenberg SO, Knopp MV, Londy F, et al. (2002) Morphologic and functional magnetic resonance imaging of renal artery stenosis: a multireader tricenter study. J Am Soc Nephrol 13:158–169
Yim PJ, Cebral JR, Weaver A, et al. (2004) Estimation of the differential pressure at renal artery stenoses. Magn Reson Med 51:969–977
Grenier N, Basseau F, Ries M, et al. (2004) Functional MRI of the kidney. Abdom Imaging 28:164–175
Michaely HJ, Schoenberg SO, Ittrich C, et al. (2004) Renal disease: value of functional magnetic resonance imaging with flow and perfusion measurements. Invest Radiol 39:698–705
Huang AJ, Lee VS, Rusinek H (2004) Functional renal MR imaging. Magn Reson Imaging Clin N Am 12:469–486
Gandy SJ, Sudarshan TAP, Sheppard DG, et al. (2003) Dynamic MRI contrast enhancement of renal cortex: a functional assessment of renovascular disease in patients with renal artery stenosis. J Magn Reson Imaging 18:461–466
Juillard L, Lerman LO, Kruger DG, et al. (2004) Blood oxygen-level dependent measurement of acute intra-renal ischemia. Kidney Int 65:944–950
Van den Brink JS, Watanabe Y, Kuhl CK, et al. (2003) Implications of SENSE MR in routine clinical practice. Eur J Radiol 46:3–27
Glockner JF, Hu HH, Stanley DW, et al. (2005) Parallel imaging: a user’s guide. Radiographics 25:1279–1297
Katoh M, Spuentrup E, Stuber M, et al. (2005) Free-breathing renal magnetic resonance angiography with steady-state free-precession and slab-selective spin inversion combined with radial k-space sampling and water-selective excitation. Magn Reson Med 53:1228–1233
Coenegrachts KL, Hoogeveen R, Vaninbroukx JA, et al. (2004) High spatial resolution 3D balanced turbo field echo technique for MR angiography of the renal arteries: initial experience. Radiology 231:237–242
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Glockner, J.F., Vrtiska, T.J. Renal MR and CT angiography: current concepts. Abdom Imaging 32, 407–420 (2007). https://doi.org/10.1007/s00261-006-9066-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-006-9066-3