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Time-resolved contrast-enhanced MR angiography of renal artery stenosis: diagnostic accuracy and interobserver variability.

AbstractOBJECTIVE:
The purpose of this study was to evaluate diagnostic accuracy and interobserver variability of time-resolved three-dimensional gadolinium-enhanced MR angiography in the detection of renal artery stenosis in comparison with intraarterial digital subtraction angiography as the standard of reference.
SUBJECTS AND METHODS:
Forty consecutive patients (age range, 25-81 years; mean, 62.9 +/- 11.9 years) with suspected renal artery stenosis underwent intraarterial digital subtraction angiography and gadolinium-enhanced MR angiography, performed on a 1.5-T system with fast low-angle shot three-dimensional imaging (3.8/1.49 [TR/TE], 25 degrees flip angle, 10-sec acquisition time, and 1.5-mm partition thickness). Three time-resolved phases were obtained in a single breath-hold. Digital subtraction angiography and gadolinium-enhanced MR angiography were evaluated by four observers who studied 80 main renal arteries and 19 accessory vessels to evaluate the degree of stenosis. A stenosis reducing the intraarterial diameter by more than 50% was regarded as hemodynamically significant. Interobserver variability was calculated.
RESULTS:
Only one gadolinium-enhanced MR angiography study was not of diagnostic quality, as a result of failure of the power injector. All main branches were of diagnostic quality in 38 (97.4%) of the remaining 39 gadolinium-enhanced MR angiography studies. Seventeen (89.5%) of 19 accessory renal arteries were depicted with gadolinium-enhanced MR angiography. The overall sensitivity for significant stenoses was 92.9%. The overall specificity was 83.4%, and the overall accuracy was 85.9%. Interobserver variability of gadolinium-enhanced MR angiography exceeded that of digital subtraction angiography.
CONCLUSION:
Time-resolved three-dimensional gadolinium-enhanced MR angiography is a useful noninvasive method of screening suspected renal artery stenosis because of its easy application, short examination time, and high sensitivity despite of its higher interobserver variability.
AuthorsM Völk, M Strotzer, M Lenhart, C Manke, W R Nitz, J Seitz, S Feuerbach, J Link
JournalAJR. American journal of roentgenology (AJR Am J Roentgenol) Vol. 174 Issue 6 Pg. 1583-8 (Jun 2000) ISSN: 0361-803X [Print] United States
PMID10845486 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Contrast Media
  • Gadolinium DTPA
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography, Digital Subtraction
  • Contrast Media
  • Female
  • Gadolinium DTPA
  • Humans
  • Magnetic Resonance Angiography
  • Male
  • Middle Aged
  • Observer Variation
  • Prospective Studies
  • Renal Artery (diagnostic imaging, pathology)
  • Renal Artery Obstruction (diagnosis, diagnostic imaging)
  • Sensitivity and Specificity

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