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Renal artery stenosis: comparative assessment by unenhanced renal artery mra versus contrast-enhanced MRA

  • Magnetic Resonance
  • Published:
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Abstract

Objectives

To evaluate steady-state free precession (SSFP) non-contrast-enhanced MR angiography (Unenhanced-MRA) versus conventional contrast-enhanced MR angiography (CE-MRA) in the detection of renal artery stenosis (RAS).

Methods

Retrospective analysis of 70 consecutive patients referred for suspected RAS, examined by SSFP Unenhanced-MRA and CE-MRA. Image quality, quality of visible renal arterial segments, presence and grade of RAS were evaluated. The Unenhanced-MRA were compared against reference standard CE-MRA results.

Results

149 renal arteries were assessed with 21 haemodynamically significant stenoses (≥50% stenosis) demonstrated by CE-MRA. Combined sensitivity and specificity for RAS detection by Unenhanced-MRA was 72.8% and 97.8% respectively. There is substantial correlation for RAS detection between Unenhanced-MRA and CE-MRA with kappa values of between 0.64 and 0.74. There was excellent inter-observer correlation for RAS on Unenhanced-MRA (kappa values 0.82–1.0).

Conclusions

Our study has shown Unenhanced-MRA to be a viable alternative to CE-MRA, yielding images equal in quality without the requirement for gadolinium contrast agents. The sensitivity and specificity for the detection of haemodynamically significant stenoses are comparable to CE-MRA. Potentially, Unenhanced-MRA could be used as an initial investigation to avoid performing CE-MRA in patients with normal renal arteries, however we suggest that its real value will lie in being complementary to CE-MRA.

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Acknowledgements

The authors thank Lauren Sundblom and Warren Casperz, Senior MRI Radiographers, St Mary’s Hospital for technical assistance and Dr Alexander Leff, Consultant Neurologist and Senior Lecturer, University College London Hospitals Trust for statistical advice.

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Authors and Affiliations

  1. Department of MRI, St Mary’s Hospital, Imperial College NHS Trust, London, UK

    Michael M. Y. Khoo, Dhafer Deeab, Wladyslaw M. W. Gedroyc & Elizabeth A. Dick

  2. Department of Nephrology, Hammersmith Hospital, Imperial College NHS Trust, London, UK

    Neil Duncan & David Taube

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  1. Michael M. Y. Khoo
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  2. Dhafer Deeab
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Correspondence to Michael M. Y. Khoo.

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Khoo, M.M.Y., Deeab, D., Gedroyc, W.M.W. et al. Renal artery stenosis: comparative assessment by unenhanced renal artery mra versus contrast-enhanced MRA. Eur Radiol 21, 1470–1476 (2011). https://doi.org/10.1007/s00330-011-2086-6

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  • DOI: https://doi.org/10.1007/s00330-011-2086-6

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