Advertisement

Renal MR Angiography

  • James F. GlocknerEmail author
Chapter

Abstract

Renal MR angiography is frequently performed for noninvasive assessment of the renal arteries, usually in the setting of hypertension or renal insufficiency unresponsive to medical therapy. A variety of techniques are currently available, and examinations can be performed with or without intravenous gadolinium contrast agents. The most common contrast-enhanced and non-contrast techniques will be reviewed, along with their advantages and disadvantages, followed by a discussion of the various clinical indications for renal MRA, including an examination of the true accuracy of renal MRA for detecting clinically significant renal artery stenosis. Finally, recent and future developments in the field are assessed.

Keywords

MR angiography MRI Non-contrast MRA Contrast-enhanced MRA Phase contrast MRA Renal artery stenosis Atherosclerosis Hypertension 

References

  1. 1.
    Prince MR, Yucel EK, Kaufman JA, et al. Dynamic gadolinium-enhanced three-dimensional abdominal MR arteriography. J Magn Reson Imaging. 1993;3:877–81.PubMedCrossRefGoogle Scholar
  2. 2.
    Schoenberg SO, Rieger J, Weber CH, et al. High spatial resolution MR angiography of renal arteries with integrated parallel acquisitions: comparison with digital subtraction angiography and US. Radiology. 2005;235:687–98.PubMedCrossRefGoogle Scholar
  3. 3.
    Kramer U, Kambiz N, Laub G, et al. High-resolution magnetic resonance angiography of the renal arteries using parallel imaging acquisition techniques at 3.0 T. Invest Radiol. 2006;41:125–32.PubMedCrossRefGoogle Scholar
  4. 4.
    Stacul F, Gava S, Belgrano M, et al. Renal artery stenosis: comparative evaluation of gadolinium-enhanced MRA and DSA. Radiol Med. 2008;113:529–46.PubMedCrossRefGoogle Scholar
  5. 5.
    Slanina M, Zizka J, Kizo L, et al. Contrast-enhanced MR angiography utilizing parallel acquisition techniques in renal artery stenosis detection. Eur J Radiol. 2010;75:e46–50.PubMedCrossRefGoogle Scholar
  6. 6.
    Cowper SE, Robin HS, Steinberg SM, et al. Scleromyxoedema-like cutaneous diseases in renal dialysis patients. Lancet. 2000;356:1000–1.PubMedCrossRefGoogle Scholar
  7. 7.
    Grobner T. Gadolinium – a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis? Nephrol Dial Transplant. 2006;21:1104–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Weinreb JC, Kuo PH. Nephrogenic systemic fibrosis. Magn Reson Imaging Clin N Am. 2009;17:159–67.PubMedCrossRefGoogle Scholar
  9. 9.
    Miyazaki M, Akahane M. Non-contrast enhanced MR angiography: established techniques. J Magn Reson Imaging. 2012;35:1–19.PubMedCrossRefGoogle Scholar
  10. 10.
    Maki JH, Wilson GJ, Eubank WB, et al. Steady-state free precession MRA of the renal arteries: breath-hold and navigator-gated techniques vs. CE-MRA. J Magn Reson Imaging. 2007;26:966–73.PubMedCrossRefGoogle Scholar
  11. 11.
    Wyttenbach R, Braghetti A, Wyss M, et al. Renal artery assessment with nonenhanced steady-state free precession versus contrast-enhanced MR angiography. Radiology. 2007;25:186–95.CrossRefGoogle Scholar
  12. 12.
    Glockner JF, Takahashi N, Kawashima A, et al. Non-contrast renal artery MRA using an inflow inversion recovery steady state free precession technique (Inhance): comparison with 3D contrast-enhanced MRA. J Magn Reson Imaging. 2010;31:1411–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Mohrs OK, Petersen SE, Schulze T, et al. High-resolution 3D unenhanced ECG-gated respiratory-navigated MR angiography of the renal arteries: comparison with contrast-enhanced MR angiography. AJR Am J Roentgenol. 2010;195:1423–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Khoo MMY, Deeab D, Gedroye WMW, et al. Renal artery stenosis: comparative assessment by unenhanced renal artery MRA versus contrast-enhanced MRA. Eur Radiol. 2011;21:1470–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Duda SH, Schick F, Teufl F, et al. Phase-contrast MR angiography for detection of atherosclerotic renal artery stenosis. Acta Radiol. 1997;38:287–91.PubMedCrossRefGoogle Scholar
  16. 16.
    Miller S, Schick F, Duda SH, et al. Gd-enhanced 3D phase-contrast MR angiography and dynamic perfusion imaging in the diagnosis of renal artery stenosis. Magn Reson Imaging. 1998;16:1005–12.PubMedCrossRefGoogle Scholar
  17. 17.
    Hood MN, Ho VB, Corse WR. Three-dimensional phase-contrast magnetic resonance angiography: a useful clinical adjunct to gadolinium-enhanced three-dimensional renal magnetic resonance angiography? Mil Med. 2002;167:343–9.PubMedGoogle Scholar
  18. 18.
    Michaely HJ, Schoenberg SO, Ittrich C, et al. Renal disease: value of functional magnetic resonance imaging with flow and perfusion measurements. Invest Radiol. 2004;39:698–705.PubMedCrossRefGoogle Scholar
  19. 19.
    Zhang HL, Schoenberg SO, Resnick LM, et al. Diagnosis of renal artery stenosis: combining gadolinium-enhanced three-dimensional magnetic resonance angiography with functional magnetic resonance pulse sequences. Am J Hypertens. 2003;16:1079–82.PubMedCrossRefGoogle Scholar
  20. 20.
    Schoenberg SO, Knopp MV, Londy F, et al. Morphologic and functional magnetic resonance imaging of renal artery stenosis: a multireader tricenter study. J Am Soc Nephrol. 2002;13:158–69.PubMedGoogle Scholar
  21. 21.
    Yim PJ, Cebral JR, Weaver A, et al. Estimation of the differential pressure at renal artery stenoses. Magn Reson Med. 2004;51:969–77.PubMedCrossRefGoogle Scholar
  22. 22.
    Iozelli A, D’Orta G, Aliprandi A, et al. The value of true-FISP sequence added to conventional gadolinium-enhanced MRA of the abdominal aorta and its major branches. Eur J Radiol. 2009;72:489–93.CrossRefGoogle Scholar
  23. 23.
    Tan KT, Van Beek EJR, Brown PWG, et al. Magnetic resonance angiography for the diagnosis of renal artery stenosis: a meta-analysis. Clin Radiol. 2002;57:617–24.PubMedCrossRefGoogle Scholar
  24. 24.
    Boudewijn G, Vasbinder C, Nelemans PJ, et al. Diagnostic tests for renal artery stenosis in patients suspected of having renovascular hypertension: a meta-analysis. Ann Intern Med. 2001;135:401–11.CrossRefGoogle Scholar
  25. 25.
    Boudewijn G, Vasbinder C, Nelemans PJ, et al. Accuracy of computed tomographic angiography and magnetic resonance angiography for diagnosing renal artery stenosis. Ann Intern Med. 2004;141:674–82.CrossRefGoogle Scholar
  26. 26.
    Soulez G, Pasowicz M, Benea G, et al. Renal artery stenosis evaluation: diagnostic performance of gadobenate dimeglumine-enhanced MR angiography – comparison with DSA. Radiology. 2008;247:273–85.PubMedCrossRefGoogle Scholar
  27. 27.
    Schneider G, Pasowicz M, Vymazal J, et al. Gadobenate dimeglumine and gadofosveset trisodium for MR angiography of the renal arteries: multicenter intraindividual crossover comparison. AJR Am J Roentgenol. 2010;195:476–85.PubMedCrossRefGoogle Scholar
  28. 28.
    Rountas C, Vlychou M, Vassiou K, et al. Imaging modalities for renal artery stenosis in suspected renovascular hypertension: prospective intraindividual comparison of color Doppler US, CT angiography, gd-enhanced MR angiography, and digital subtraction angiography. Ren Fail. 2007;29:295–302.PubMedCrossRefGoogle Scholar
  29. 29.
    Lee CU, Glockner JF. Vascular staging of renal and adrenal malignancies with a noncontrast enhanced steady state free precession technique. J Magn Reson Imaging. 2011;33:1406–13.PubMedCrossRefGoogle Scholar
  30. 30.
    Hussain SM, Kock MCJM, Ijzermans JNM, et al. MR imaging: a one stop shop modality for peroperative evaluation of potential living kidney donors. Radiographics. 2003;23:505–20.PubMedCrossRefGoogle Scholar
  31. 31.
    Tan SP, Bux SI, Kumar G, et al. Evaluation of live renal donors with three-dimensional contrast-enhanced magnetic resonance angiography in comparison to catheter angiography. Transplant Proc. 2004;36:1914–6.PubMedCrossRefGoogle Scholar
  32. 32.
    Rajab A, Khabiri H, Pelletier RP, et al. Magnetic resonance angiography for preoperative evaluation of potential kidney donors. J Surg Res. 2004;120:195–200.PubMedCrossRefGoogle Scholar
  33. 33.
    Al-Saeed O, Ismail M, Sheikh M, et al. 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. 2005;49:214–7.PubMedCrossRefGoogle Scholar
  34. 34.
    Bhatti AA, Chugtai A, Haslam P, et al. Prospective study comparing three-dimensional computed tomography and magnetic resonance imaging for evaluating renal vascular anatomy in potential living donors. BJU Int. 2005;96:1105–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Jain R, Sawhney S. Contrast-enhanced MR angiography (CE-MRA) in the evaluation of vascular complications of renal transplantation. Clin Radiol. 2005;60:1171–81.PubMedCrossRefGoogle Scholar
  36. 36.
    Gufler H, Weimer W, Neu K, Wagner S, Rau WS. Contrast enhanced MR angiography with parallel imaging in the early period after renal transplantation. J Magn Reson Imaging. 2009;29:909–16.PubMedCrossRefGoogle Scholar
  37. 37.
    Liu X, Berg N, Sheehan J, et al. Renal transplant: nonenhanced renal MR angiography with magnetization-prepared steady-state free precession. Radiology. 2009;251:535–42.PubMedCrossRefGoogle Scholar
  38. 38.
    Browne RFJ, Riordan EO, Roberts JA, et al. Renal artery aneurysms: diagnosis and surveillance with 3D contrast-enhanced magnetic resonance angiography. Eur Radiol. 2004;14:1807–12.PubMedCrossRefGoogle Scholar
  39. 39.
    Van den Brink JS, Watanabe Y, Kuhl CK, et al. Implications of SENSE MR in routine clinical practice. Eur J Radiol. 2003:46:3–27.Google Scholar
  40. 40.
    Glockner JF, Hu HH, Standley DW, et al. Parallel imaging: a user’s guide. Radiographics. 2005;25:1279–97.PubMedCrossRefGoogle Scholar
  41. 41.
    Nchimi A, Brisbois D, Materne R, et al. Free-breathing accelerated gadolinium-enhanced MR angiography in the diagnosis of renovascular disease. AJR Am J Roentgenol. 2009;192:1531–7.PubMedCrossRefGoogle Scholar
  42. 42.
    Morelli JN, Fei A, Runge VM, et al. Time-resolved MR angiography of renal artery stenosis in a swine model at 3 T using gadobutrol with digital subtraction angiography correlation. J Magn Reson Imaging. 2012;36:704–13.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Department of RadiologyMayo Clinic College of Medicine, Mayo ClinicRochesterUSA

Personalised recommendations