title: Effect of MR angiography on the diagnosis and treatment of patients with suspected renovascular disease.
abstract: OBJECTIVE
  Although the diagnostic accuracy of renal magnetic resonance (MR) angiography is established, its effect on referring physicians is unknown. The authors prospectively measured the effect of MR angiography results on referring physicians' diagnosis and treatment (plans) of patients with suspected renovascular disease.
  
  
  METHODS
  Referring physicians prospectively completed questionnaires before and after MR angiography was performed during evaluation of their patients with suspected renovascular disease. The questionnaires asked them to estimate the probability (0%-100%) of their most likely diagnosis before and after receiving the imaging information. They were also asked for their anticipated and final treatment plans. The authors calculated the mean gain in diagnostic percentage confidence and the proportion of patients with changed initial diagnoses or anticipated management. A paired t-test was used to assess significance of the gains in diagnostic percentage confidence.
  
  
  RESULTS
  Physicians prospectively completed pre- and post-MR-angiography questionnaires for 30 patients. MR angiography improved mean diagnostic certainty by 35% (P < .0001). MR angiography changed physicians' initial diagnoses in 12 patients (40%). Anticipated treatment plans were changed in 20 patients (67%). Invasive procedures were avoided in eight patients (27%).
  
  
  CONCLUSIONS
  MR angiography has a substantial effect on the diagnostic and therapeutic decision-making of physicians managing patients with suspected renovascular disease.
authors.affiliation: Department of Radiology, Northwestern University Medical School, Chicago, Illinois 60611, USA. romary@radiology.northwestern.edu
authors.forename: R A
authors.initials: RA
authors.lastname: Omary
authors.forename: K P
authors.initials: KP
authors.lastname: Henseler
authors.forename: R
authors.initials: R
authors.lastname: Salem
authors.forename: J C
authors.initials: JC
authors.lastname: McDermott
authors.forename: I
authors.initials: I
authors.lastname: Sproat
authors.forename: M
authors.initials: M
authors.lastname: Wojtowycz
authors.forename: B N
authors.initials: BN
authors.lastname: Becker
authors.forename: C W
authors.initials: CW
authors.lastname: Acher
authors.forename: H B
authors.initials: HB
authors.lastname: Chrisman
authors.forename: M B
authors.initials: MB
authors.lastname: Saker
authors.forename: T M
authors.initials: TM
authors.lastname: Grist
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis* / Q000628:therapy; D007668:Kidney / Q000098:blood supply* / Q000473:pathology; D007674:Kidney Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011795:Surveys and Questionnaires