title: Non-contrast-enhanced MRA of renal artery stenosis: validation against DSA in a porcine model.
abstract: OBJECTIVE
  To compare 3D-inversion-recovery balanced steady-state free precession (IR-bSSFP) non-contrast-enhanced magnetic resonance angiography (MRA) with 3D-contrast-enhanced MRA (CE-MRA) for assessment of renal artery stenosis (RAS) using digital subtraction angiography (DSA) as the reference standard.
  
  
  METHODS
  Bilateral RAS were surgically created in 12 swine. IR-bSSFP and CE-MRA were acquired at 1.5 T and compared to rotational DSA. Three experienced cardiovascular radiologists evaluated the IR-bSSFP and CE-MRA studies independently. Linear regression models were used to calibrate and assess the accuracy of IR-bSSFP and CE-MRA, separately, against DSA. The coefficient of determination and Cohen's kappa coefficient were also generated.
  
  
  RESULTS
  Calibration of the three readers' RAS grading revealed R(2) values of 0.52, 0.37 and 0.59 for NCE-MRA and 0.48, 0.53 and 0.71 for CE-MRA. Inter-rater agreement demonstrated Cohen's kappa values ranging from 0.25 to 0.65. Distal renal artery branch vessels were visible to a significantly higher degree with NCE-MRA compared to CE-MRA (p < 0.001). Image quality was rated excellent for both sequences, although image noise was higher with CE-MRA (p < 0.05). In no cases did noise interfere with image interpretation.
  
  
  CONCLUSIONS
  In a well-controlled animal model of surgically induced RAS, IR-bSSFP based NCE-MRA and CE-MRA accurately graded RAS with a tendency for stenosis overestimation, compared to DSA.
  
  
  CONCLUSIONS
  • IR-bSSFP and CE-MRA are accurate methods for diagnosis of renal artery stenosis • IR-bSSFP and CE-MRA demonstrate excellent agreement with DSA • Both IR-bSSFP and CE-MRA have a tendency to overestimate renal artery stenosis.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany.|Department of Radiology, University of Wisconsin, 600 Highland Ave, E1/374, Madison, WI, 53792, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Bley
authors.affiliation: Department of Radiology, University of Wisconsin, 600 Highland Ave, E1/374, Madison, WI, 53792, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: François
authors.affiliation: Department of Radiology, University of Wisconsin, 600 Highland Ave, E1/374, Madison, WI, 53792, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Schiebler
authors.affiliation: Department of Radiology, University of Wisconsin, 600 Highland Ave, E1/374, Madison, WI, 53792, USA.|Department of Medical Physics, University of Wisconsin, Madison, WI, USA.
authors.forename: O
authors.initials: O
authors.lastname: Wieben
authors.affiliation: MR Applied Sciences Laboratory, GE Healthcare, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Takei
authors.affiliation: Department of Radiology, University of Wisconsin, 600 Highland Ave, E1/374, Madison, WI, 53792, USA.|MR Applied Sciences Laboratory, GE Healthcare, Madison, WI, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Brittain
authors.affiliation: Department of Radiology, University of Wisconsin, 600 Highland Ave, E1/374, Madison, WI, 53792, USA.|Department of Medical Physics, University of Wisconsin, Madison, WI, USA.
authors.forename: A Munoz
authors.initials: AM
authors.lastname: Del Rio
authors.affiliation: Department of Radiology, University of Wisconsin, 600 Highland Ave, E1/374, Madison, WI, 53792, USA.|Department of Medical Physics, University of Wisconsin, Madison, WI, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Grist
authors.affiliation: Department of Radiology, University of Wisconsin, 600 Highland Ave, E1/374, Madison, WI, 53792, USA. sreeder@uwhealth.org.|Department of Medical Physics, University of Wisconsin, Madison, WI, USA. sreeder@uwhealth.org.|Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA. sreeder@uwhealth.org.|Department of Medicine, University of Wisconsin, Madison, WI, USA. sreeder@uwhealth.org.|Department of Emergency Medicine, University of Wisconsin, Madison, WI, USA. sreeder@uwhealth.org.
authors.forename: S B
authors.initials: SB
authors.lastname: Reeder
mesh_terms: D015901:Angiography, Digital Subtraction / Q000379:methods*; D000818:Animals; D003287:Contrast Media; D004195:Disease Models, Animal; D021621:Imaging, Three-Dimensional / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D012077:Renal Artery / Q000473:pathology; D012078:Renal Artery Obstruction / Q000175:diagnosis / Q000473:pathology*; D015203:Reproducibility of Results; D013552:Swine
chemical_list: D003287:Contrast Media
keywords: Digital subtraction angiography; Magnetic resonance imaging; Non-contrast magnetic resonance angiography; Renal artery stenosis