title: Preoperative evaluation of renal artery in patients with renal tumor: Using noncontrast-enhanced magnetic resonance angiography.
abstract: To investigate the feasibility of the noncontrast-enhanced magnetic resonance angiography (NCE-MRA) to evaluate renal arteries before partial nephrectomy (PN).Retrospective analyzed 479 patients who underwent renal surgery between January 2013 and December 2015 with NCE-MRA or computed tomographic angiography (CTA) renal artery image reconstruction preoperative in our department. The renal artery reconstruction score (RARS) was based on the level of artery visualization in a 4-class criterion, and the R.E.N.A.L nephrometry score (R.E.N.A.L), arterial based complexity (ABC) were also analyzed.Of the 479 patients, the overall-lever RARS was 3.62, and the average in 2 groups was no significant difference (NCE-MRA vs CTA, P = 0.072). The performance of NCE-MRA in PN group was similar with CTA. Further comparison demonstrated that the efficiency of NCE-MRA in moderate- or low-degree tumor according to the R.E.N.A.L and ABC complexity less than 3S was equal to CTA. However, high degree (P < 0.001), 3S (P = 0.027), or 3H (P < 0.001) would affect the imaging of renal artery. Intragroup analysis showed that tumor complexity such as max tumor size (r = -o.351, P < 0.001), R.E.N.A.L (r = -0.439, P < 0.001), and ABC (r = -0.619, P < 0.001) were closely correlated with the NCE-MRA performance. The images of 2 sides of the kidney were compared in single person as well, which was meaningful for NCE-MRA patients only (NCE-MRA, P < 0.001; CTA, P = 0.182).The renal artery reconstruction performed by NCE-MRA is feasible and has a similar achievement in the PN potential recipients, with a lower side effect, and meets the requirements for making surgical decision. It has a broad application prospect in clinical practice; however, it still needs to further improve the ability in more complex tumors.
authors.affiliation: Department of Urology Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Liangsong
authors.initials: L
authors.lastname: Zhu
authors.forename: Guangyu
authors.initials: G
authors.lastname: Wu
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Wang
authors.forename: Jiwei
authors.initials: J
authors.lastname: Huang
authors.forename: Wen
authors.initials: W
authors.lastname: Kong
authors.forename: Yonghui
authors.initials: Y
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Xue
authors.forename: Yiran
authors.initials: Y
authors.lastname: Huang
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000601:surgery; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011300:Preoperative Care / Q000379:methods*; D012077:Renal Artery / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media