Renal arterial stenosis: prospective comparison of color Doppler US and breath-hold, three-dimensional, dynamic, gadolinium-enhanced MR angiography.
OBJECTIVE
To compare color Doppler ultrasonography (US) with fast, breath-hold, three-dimensional, gadolinium-enhanced magnetic resonance (MR) angiography in detecting renal arterial stenosis.


METHODS
Forty-five patients with clinical suspicion of renovascular disease were prospectively examined with intra- and extrarenal color Doppler US and breath-hold, gadolinium-enhanced MR angiography. Digital subtraction arteriography (DSA) was the standard of reference in all patients for the number of renal arteries and degree of stenosis.


RESULTS
DSA depicted 103 arteries and 52 stenoses. Color Doppler US was nondiagnostic in two examinations. Significantly more of 13 accessory renal arteries were detected with MR angiography (n = 12) than with color Doppler US (n = 3; P <.05). For assessing all stenoses, the sensitivity and accuracy were 94% and 91%, respectively, for MR angiography and 71% and 76%, respectively, for US (P <.05). The sensitivity was higher for MR angiography (100%) than for US (79%; P <.05) in diagnosing stenoses with at least 50% narrowing. The specificity, accuracy, and negative predictive value in diagnosing stenoses of at least 50% narrowing were 93%, 95%, and 100% for MR angiography and 93%, 89%, and 90% for US.


CONCLUSIONS
Breath-hold, gadolinium-enhanced MR angiography is superior to color Doppler US in accessory renal artery detection. Although the specificity of MR angiography is similar to that of color Doppler US, MR angiography has a better sensitivity and negative predictive value in depicting renal arterial stenoses.
De Cobelli
F
F
Department of Radiology, Scientific Institute S Raffaele, University Hospital, Olgettina 60, 20132 Milan, Italy. francesco.decobelli@hsr.it
Venturini
M
M
Vanzulli
A
A
Sironi
S
S
Salvioni
M
M
Angeli
E
E
Scifo
P
P
Garancini
M P
MP
Quartagno
R
R
Bianchi
G
G
Del Maschio
A
A
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000473:pathology; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012119:Respiration; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color
D003287:Contrast Media; D019786:Gadolinium DTPA