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Vascular and Interventional Radiology |
1 From the Department of Radiology, German Cancer Research Center (dkfz), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany (S.O.S., M.B., M.V.K., M.E., H.H., I.Z., G.v.K.); Siemens Medical Systems, Erlangen, Germany (G.L.); and the Department of Surgery, University Hospitals, Heidelberg, Germany (F.K.). Received December 3, 1997; revision requested January 22; revision received September 21; accepted November 5. Supported in part by a grant from the Verein zur Foerderung der Krebserkennung und Krebsvorsorge, e.V. Address reprint requests to S.O.S.
PURPOSE: To compare two different three-dimensional (3D) gadolinium-enhanced magnetic resonance (MR) angiographic techniques.
MATERIALS AND METHODS: In 26 patients suspected of having renal artery stenosis, results with fast multiphase 3D MR angiography were compared to those with standard 3D MR angiography in 37 patients. With both techniques, 31-second breath-hold acquisitions were performed. Multiphase angiography comprised five discrete 6.4-second acquisitions without bolus timing, and standard angiography comprised a single acquisition based on test-bolus timing. Two readers evaluated images obtained with both techniques in terms of image quality, artifacts, and vessel conspicuity. Accuracy of findings on the multiphase 3D MR angiograms for assessment of renal artery stenosis was determined by comparing them to digital subtraction angiograms and surgical findings.
RESULTS: In the early arterial phase, multiphase 3D MR angiograms showed no image degradation by venous overlay, whereas standard 3D MR angiograms depicted at least minor overlay in 53 of 83 renal arteries (P < .001). Less parenchymal enhancement in the early arterial phase resulted in a higher vessel conspicuity for the divisions and segmental arteries (P < .001). Both readers detected and correctly graded 18 of 20 stenoses on the multiphase angiograms with almost perfect interobserver agreement (
> 0.89).
CONCLUSION: Renal multiphase 3D MR angiography is an accurate technique requiring no bolus timing. The performance of early arterial phase imaging leads to improved depiction, particularly of the distal renovascular tree, compared to that with standard single-phase 3D MR angiography.
Index terms: Magnetic resonance (MR), maximum intensity projection, 961.12949 • Magnetic resonance (MR), three-dimensional, 961.12942, 961.149, 961.721 • Magnetic resonance (MR), vascular studies, 961.12942, 961.149, 961.721 • Renal arteries, MR, 961.12942, 961.149, 961.721
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