title: Gadolinium-enhanced magnetic resonance angiography in renal artery stenosis: comparison with digital subtraction angiography.
abstract: OBJECTIVE
  To evaluate the accuracy of gadolinium-enhanced magnetic resonance angiography in assessing renal artery stenosis compared to catheter digital subtraction angiography.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Singapore General Hospital.
  
  
  METHODS
  Records of patients who underwent magnetic resonance angiography as well as digital subtraction angiography for assessment of renal artery stenosis from January 2003 to December 2005 were reviewed.
  
  
  RESULTS
  There were 27 patients (14 male, 13 female) with a mean age of 62 (range, 44-77) years. There were 10 patients with renal transplants; their native renal arteries were not evaluated. Each of the two experienced interventional and body magnetic resonance radiologists, who were blinded to the results, reviewed the digital subtraction angiography and magnetic resonance angiography images respectively. Digital subtraction angiography was used as the standard of reference. A total of 39 renal arteries from these 27 patients were evaluated. One of the arteries was previously stented and could not be assessed with magnetic resonance angiography due to severe artefacts. Of the remaining 38 renal arteries, two were graded as normal, seven as having mild stenosis (<50%), eight as having moderate stenosis (> or =50% but <75%), and 21 as having severe stenosis (> or =75%). Magnetic resonance angiography and digital subtraction angiography were concordant in 89% of the arteries; magnetic resonance angiography overestimated the degree of stenosis in 8% and underestimated it in 3% of them. In the evaluation of clinically significant renal artery stenosis (> or =50%) with magnetic resonance angiography, the overall sensitivity, specificity, positive predictive value, and negative predictive value were 97%, 67%, 90%, and 86% respectively. The sensitivity and specificity of magnetic resonance angiography in transplant renal artery stenosis was 100%. CONCLUSION. Our experience suggested that gadolinium-enhanced magnetic resonance angiography is a sensitive non-invasive modality useful in the assessment of clinically significant renal artery stenosis.
authors.affiliation: Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608. yanmee@hotmail.com
authors.forename: Y M
authors.initials: YM
authors.lastname: Law
authors.forename: K H
authors.initials: KH
authors.lastname: Tay
authors.forename: Y U
authors.initials: YU
authors.lastname: Gan
authors.forename: F K
authors.initials: FK
authors.lastname: Cheah
authors.forename: B S
authors.initials: BS
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D016477:Artifacts; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D016030:Kidney Transplantation; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D012078:Renal Artery Obstruction / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012846:Singapore
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA