Renal artery stenosis: evaluation with breath-hold, three-dimensional, dynamic, gadolinium-enhanced versus three-dimensional, phase-contrast MR angiography.
OBJECTIVE
To compare breath-hold, three-dimensional, gadolinium-enhanced magnetic resonance (MR) angiography with three-dimensional, phase-contrast MR angiography in the evaluation of renal artery stenosis.


METHODS
Fifty-five consecutive adult patients with clinical suspicion of renovascular disease were prospectively examined with three-dimensional, phase-contrast MR angiography and breath-hold, three-dimensional MR angiography with injection of a standard dose of gadopentetate dimeglumine to evaluate the number of renal arteries and the presence and degree of stenosis. The standard of reference was intraarterial digital subtraction angiography.


RESULTS
Gadolinium-enhanced MR angiography depicted all 105 main renal arteries, whereas phase-contrast MR angiography depicted 104. The number of accessory renal arteries depicted was significantly higher with gadolinium-enhanced (17 of 18) than with phase-contrast (11 of 18) studies (P = .04). Both techniques depicted 27 of the 29 stenoses (sensitivity, 93%; P > .05). Sensitivities, specificities, and accuracies in the diagnosis of hemodynamically significant stenosis (> 50% narrowing) were, respectively, 94%, 96%, and 96% for phase-contrast and 100%, 97%, and 98% for gadolinium-enhanced MR angiography (P > .05).


CONCLUSIONS
Gadolinium-enhanced MR angiography is superior to phase-contrast MR angiography in accessory renal artery depiction. No statistically significant difference in the assessment of stenosis has been found between the two techniques.
De Cobelli
F
F
Department of Radiology, University Hospital, Scientific Institute San Raffaele, Milan, Italy.
Vanzulli
A
A
Sironi
S
S
Mellone
R
R
Angeli
E
E
Venturini
M
M
Garancini
M P
MP
Quartagno
R
R
Bianchi
G
G
Del Maschio
A
A
D000368:Aged; D015901:Angiography, Digital Subtraction; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D012077:Renal Artery / Q000473:pathology; D012078:Renal Artery Obstruction / Q000175:diagnosis*; D012680:Sensitivity and Specificity
D003287:Contrast Media; D019786:Gadolinium DTPA