Comparison of digital subtraction angiography with gadolinium-enhanced magnetic resonance angiography in the diagnosis of renal artery stenosis.
Renal artery stenosis (RAS) is a treatable cause of hypertension and renal failure for which no ideal screening technique is currently available. We evaluated the use of dynamic gadolinium-enhanced magnetic resonance angiography (MRA) for the diagnosis of RAS. Sixty-two patients with secondary hypertension were enrolled in the study. All patients had conventional renal angiography and gadolinium enhanced MRA. The sequence used was a 3D FMP SPGR sequence with the following parameters (TR: 26 ms, TE: 6.9 ms, flip angle 40 degrees, field of view 36 x 36 cm, matrix 246 x 256, 1 excitation). Gadolinium 0.3 mmol/kg was administered and 60 1. 5-mm-thick partitions were obtained over a duration of 3.5 min. The MRA images were then compared with conventional digital subtraction angiography (DSA) images. Conventional DSA demonstrated 138 renal arteries, whereas gadolinium-enhanced MRA demonstrated 129 (93 %). Twenty-one renal artery stenoses and four occluded arteries were seen at conventional DSA. Gadolinium-enhanced MRA had a sensitivity of 88 %, specificity of 98 %, accuracy of 96 %, positive predictive value of 92 % and negative predictive value of 97 % when compared with conventional DSA. Gadolinium-enhanced MRA is an accurate technique for identifying patients with RAS. It is less sensitive in picking up accessory renal arteries.
Thornton
J
J
Department of Radiology Beaumont Hospital, Dublin 9, Ireland; and Royal College of Surgeons in Ireland, Dublin 2, Ireland.
O'Callaghan
J
J
Walshe
J
J
O'Brien
E
E
Varghese
J C
JC
Lee
M J
MJ
D015901:Angiography, Digital Subtraction; D003287:Contrast Media; D005682:Gadolinium; D006801:Humans; D018810:Magnetic Resonance Angiography; D011237:Predictive Value of Tests; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000473:pathology; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity
D003287:Contrast Media; D005682:Gadolinium