Evaluation of renovascular hypertension: comparison of functional MRI and contrast-enhanced MRA with a routinely performed renal scintigraphy and DSA.
OBJECTIVE
The main objective of this study was to evaluate a clinically suspected renovascular hypertension (RVH) by means of MRI. It was to find out if functional MRI (fMRI) is able to provide adequate results with regard to MAG3 captopril scintigraphy and if contrast-enhanced MR angiography (MRA) is able to provide adequate results in the stenosis grading compared with the nonselective digital subtraction angiography (DSA).


METHODS
This open, monocentric, prospective, phase 3 study included patients with a clinically suspected RVH. For fMRI a dynamic TurboFLASH sequence and for MRA a single-shot breath-hold flash 3D sequence was performed. Gadodiamide was injected as contrast medium.


RESULTS
Sixty patients were included in the study. The correlation between fMRI and scintigraphy had an accuracy, a sensitivity, and a specificity of 69%, 5%, and 92%, respectively, and correlations between MRA and DSA of 95%, 92%, and 96%.


CONCLUSIONS
The noninvasive MRA can replace DSA in the diagnosis of renal artery stenosis. However, fMRI can not replace renal scintigraphy.
Hackländer
Thomas
T
Department of Radiology, Helios Klinikum Wuppertal, 42283 Wuppertal, Germany. thacklaender@wuppertal.helios-kliniken.de
Mertens
Heinrich
H
Stattaus
Jörg
J
Lürken
Michaela
M
Lerch
Hartmut
H
Altenburg
Alexander
A
Rautenbach
Jeannette
J
Cramer
Bernhard M
BM
D015901:Angiography, Digital Subtraction; D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis* / Q000000981:diagnostic imaging; D007089:Image Enhancement; D007668:Kidney / Q000000981:diagnostic imaging; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012078:Renal Artery Obstruction / Q000175:diagnosis / Q000000981:diagnostic imaging; D012079:Renal Circulation / Q000502:physiology; D012680:Sensitivity and Specificity; D017263:Technetium Tc 99m Mertiatide
D000806:Angiotensin-Converting Enzyme Inhibitors; D003287:Contrast Media; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide; C064925:gadodiamide; D002216:Captopril; D019786:Gadolinium DTPA