title: Noncontrast-Enhanced Magnetic Resonance Versus Computed Tomography Angiography in Preoperative Evaluation of Potential Living Renal Donors.
abstract: OBJECTIVE
  Living renal donors undergo an extensive examination program. These examinations should be as safe, gentle, and patient friendly as possible. To compare computed tomography angiography (CTA) and an extensive magnetic resonance imaging (MRI) protocol without contrast agents to observations from nephrectomy in living renal donors and to evaluate whether noncontrast-enhanced MRI can replace CTA for vessel assessment in living renal donors.
  
  
  METHODS
  CTA and MRI results were compared to observations from nephrectomy, which served as the reference standard. Fifty-one potential kidney donors underwent imaging, and 31 donated a kidney. Comparisons in sensitivity, specificity, and accuracy were made with respect to the number of arteries, early branching, and the number of veins. Agreement was assessed using Cohen's kappa. The exact McNemar's test was used to test for statistically significant differences.
  
  
  RESULTS
  In the assessment of more than one renal artery, the sensitivity and specificity of MRI and CTA were high and in perfect agreement compared to observations from surgery. The results for both MRI and CTA were as follows: (sensitivity 100%/specificity100%/accuracy 100%/Kappa = 1/P = 1). When comparing the ability to test for early branching we found, MRI: (sensitivity 33%/specificity 100%/accuracy 87%/Kappa = 0.45/P = 1) and CTA: (sensitivity 50%/specificity 100%/accuracy 90%/Kappa = 0.62/P = 1). When used to depict supernumerary veins, we found MRI: (sensitivity60%/specifivity100%/accuracy 93%/Kappa = 0.72/P = 1), whereas CTA showed: (sensitivity 40%/specificity 96%/accuracy 87% Kappa = 0.43/P = 1).
  
  
  CONCLUSIONS
  In conclusion, an optimized MRI protocol that includes noncontrast-enhanced magnetic resonance angiography can be substituted for CTA for preoperative assessment of the renal vessels before living donor nephrectomy.
authors: Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus 8200, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Centre of Research in Rehabilitation (CORIR), Aarhus University Hospital, Aarhus, Denmark. Electronic address: anneblan@rm.dk.
authors: Anne Dorte
authors: AD
authors: Blankholm
authors: Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus 8200, Denmark.
authors: Bodil G
authors: BG
authors: Pedersen
authors: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
authors: Ernst Ø
authors: EØ
authors: Østrat
authors: Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus 8200, Denmark.
authors: Gratien
authors: G
authors: Andersen
authors: Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus 8200, Denmark.
authors: Brian
authors: B
authors: Stausbøl-Grøn
authors: Department of Clinical Medicine, Centre of Research in Rehabilitation (CORIR), Aarhus University Hospital, Aarhus, Denmark; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.
authors: Susse
authors: S
authors: Laustsen
authors: Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, MR-Research Centre, Aarhus University Hospital, Aarhus, Denmark.
authors: Steffen
authors: S
authors: Ringgaard
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D057234:Preoperative Period; D012077:Renal Artery / Q000000981:diagnostic imaging*; D012082:Renal Veins / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
keywords: Noncontrast-enhanced magnetic resonance imaging; computed tomography angiography; living donor nephrectomy; living kidney donation; living renal donation; noncontrast-enhanced magnetic resonance angiography