Intra-arterial ultra low iodine CT angiography of renal transplant arteries.
OBJECTIVE
This study was designed to evaluate the technical feasibility and the image quality of intra-arterial 320-row CT angiography (ia-CTA) in the detection of transplant renal artery stenosis (TRAS) using a very low dose of contrast agent.


METHODS
Evaluation of ia-CTA using a 4F catheter in ten patients with impaired renal transplant function and suspected TRAS. Average amount of contrast agent applied was 10 ± 3.7 ml standard deviation (SD). Patient serum creatinine levels had been monitored for 72 h. TRAS was detected and graded (1: less than 20 %; 2: 20-49 %; 3: 50-74 %; 4: 75-99 %; 5: total occlusion) and presence of kinking was recorded. Attenuation and vessel delineation were parameters for image quality analysis of the renal arterial supply, divided into four segments. Subjective image quality.


RESULTS
Ia-CTA of the renal transplant was technically successful in all patients, revealing relevant stenoses in 7 of 10 patients. Serum creatinine levels before and after ia-CTA were 2.71 ± 1.46 and 2.56 ± 1.39 mg/dl, respectively. None of the patients developed signs of contrast-induced nephropathy within 72 h. Subjective image quality was excellent in all four segments, rated by two separate readers. No segment was found to be nondiagnostic. Mean attenuation values in the arterial segments ranged between 754 and 987 Hounsfield units.


CONCLUSIONS
Wide detector ia-CTA for the diagnosis of TRAS is feasible using very low doses of contrast agent and results in high image quality.
Department of Radiology, Charité Medical School, Charitéplatz 1, 10117, Berlin, Germany, christian.althoff@charite.de.
Christian E
CE
Althoff
Rolf W
RW
Günther
Bernd
B
Hamm
Matthias
M
Rief
D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives; D007668:Kidney / Q000098:blood supply*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011857:Radiographic Image Interpretation, Computer-Assisted; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; C093233:iobitridol; D007472:Iohexol; D003404:Creatinine