Abstract | OBJECTIVE: 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.
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Authors | M Völk, M Strotzer, M Lenhart, C Manke, W R Nitz, J Seitz, S Feuerbach, J Link |
Journal | AJR. American journal of roentgenology
(AJR Am J Roentgenol)
Vol. 174
Issue 6
Pg. 1583-8
(Jun 2000)
ISSN: 0361-803X [Print] United States |
PMID | 10845486
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Contrast Media
- Gadolinium DTPA
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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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