[Preoperative examination of potential kidney transplantation donors: value of gadolinium-enhanced 3D MR angiography in comparison with DSA and urography].
OBJECTIVE
To assess a contrast-enhanced standardized MRA protocol for the presurgical evaluation of potential renal transplant donors.


METHODS
Twenty-three potential donors for renal transplantations were examined with gadolinium-enhanced, two-phase MR angiograms (1.5 T) and DSA/urography for the number of renal arteries, the presence of aberrant arterial and venous branches, renal artery stenoses and anatomy of the renal collecting system and ureters. The diagnostic value was assessed by evaluating different image processing modalities and interobserver variability.


RESULTS
Using maximum intensity projections (MIP) together with multiplanar reformatting (MPR), accessory arteries were detected with a sensitivity/specificity of 100%/98%. Depending on diagnostic experience, exclusive evaluation of MIP yielded a sensitivity/specificity of 67-100%/95-100%. Using MIP/MPR, venous depiction was good in 80%, with MIP solely in 30-40%. At least the proximal third of the ureter was visible in 67%.


CONCLUSIONS
MPR/MIP evaluation of two-phase, contrast-enhanced MRA provides an excellent depiction of renal vessel anatomy for presurgical evaluation of renal transplant donors. Exclusive MIP assessment is less reliable and depends strongly on the examiner's experience. For sufficient visualization of the ureters, either additional measurements or low-dose diuretic injection have to performed.
Winterer
J T
JT
Abteilung Röntgendiagnostik, Albert-Ludwigs-Universität Freiburg. winterja@ruf-uni-freiburg.de
Strey
C
C
Wolffram
C
C
Paul
G
G
Einert
A
A
Altehoefer
C
C
Uhrmeister
P
P
Kirste
G
G
Laubenberger
J
J
D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D007668:Kidney / Q000033:anatomy & histology* / Q000098:blood supply / Q000000981:diagnostic imaging; D016030:Kidney Transplantation; D019520:Living Donors; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012077:Renal Artery / Q000002:abnormalities / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D012082:Renal Veins / Q000002:abnormalities / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014567:Urography
D003287:Contrast Media; D005682:Gadolinium
Präoperative Untersuchung potentieller Nierenlebendspender: Wertigkeit der Gadoliniumverstärkten 3D-MR-Angiographie im Vergleich mit der DSA und Urographie.