EVALUATION OF RENAL ARTERY STENOSIS WITH GADOLINIUM-ENHANCED MR ANGIOGRAPHY
Abstract
Purpose: To determine the accuracy of gadolinium-enhanced breath-hold magnetic resonance angiography in the diagnosis of renal artery stenosis.
Material and Methods: Twenty-eight patients underwent gadolinium-enhanced magnetic resonance angiography (MRA) in order to assess renal arteries. Nine of these patients had digital subtraction angiography (DSA) for correlation. Twenty renal arteries of these nine patients were evaluated for presence or absence of renal artery stenosis, as well as location and severity of stenosis. Degree of stenosis was classified as mild (<30% narrowing), moderate (30-50% narrowing) and severe (>50% narrowing).
Results: Using DSA as a gold standard, sensitivity, specificity, positive predictive value, negative predictive value and total accuracy of MRA for detection of renal artery stenosis were 90.0, 80.0, 81.8, 88.9 and 85.0% consecutively.
Conclusion: Gadolinium-enhanced MRA is a good imaging modality with minimal invasion for screening of renal artery stenosis. The most important role of MRA is its high negative predictive value. If MRA shows no evidence of renal artery stenosis, there is no need for angiography. Angiography should be performed in positive MRA cases in order to confirm the presence of stenosis, to correctly define the degree of stenosis and eventually to perform angioplasty in certain cases.
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