Comparison of contrast enhanced MR-angiography-MRI and digital subtraction angiography in the evaluation of pancreas and/or kidney transplantation patients: initial experience.
To evaluate whether combined contrast enhanced MRA and MRI (ce-MRA-MRI) has the potential to replace intra-arterial DSA (i.a.DSA) in patients with impaired graft function or suspected of vascular complications after pancreas and/or kidney transplantation. 7 patients after combined pancreas-kidney and 22 patients after kidney transplantation underwent ce-MRA-MRI and i.a.DSA within a 3 days interval. Qualitative and quantitative comparison of the arterial and venous supply, the parenchyma and urinary collecting system was made. Both ce-MRA and i.a.DSA showed good results in the detection of arterial stenoses. However, ce-MRA falsely suggested stenoses if vascular clips were used; on the other hand, i.a.DSA was less informative if the graft arteries were very tortuous. Ce-MRA was superior in depicting the venous anatomy (p < 0.001) and the parenchymal enhancement of the pancreatic grafts. For the assessment of the contrast excretion, the pyelocalyceal system and the ureter of the renal graft ce-MRA-MRI was superior (p < 0.001), for small caliber arteries in the renal grafts i.a.DSA was of greater value (p < 0.001). The combination of ce-MRA and MRI is reliable for evaluating the vascular anatomy and has several advantages over i.a.DSA after pancreas and/or kidney transplantation. It can replace i.a.DSA in patients with impaired graft function or suspected of vascular complications after pancreas and/or kidney transplantation.
Boeve
W J
WJ
Department of Radiology, University Hospital Groningen, Groningen, The Netherlands. w.j.boeve@rad.AZG.nl
Kok
T
T
Tegzess
A M
AM
van Son
W J
WJ
Ploeg
R J
RJ
Sluiter
W J
WJ
Kamman
R L
RL
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D016477:Artifacts; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis; D006801:Humans; D007089:Image Enhancement; D007511:Ischemia / Q000175:diagnosis; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000502:physiology*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply; D016035:Pancreas Transplantation / Q000502:physiology*; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests