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High-Spatial-Resolution Contrast-enhanced MR Angiography of the Renal Arteries: A Prospective Comparison with Digital Subtraction Angiography¹

¹ From the Magnetic Resonance Laboratory, Mayo Clinic, 200 1st St SW, Rochester, MN 55905. Received February 16, 2000; revision requested March 27; revision received May 1; accepted May 22. Supported by National Institutes of Health grants CA37993 and HL37310 and GE Medical Systems. Address correspondence to S.J.R. (e-mail: riederer@mayo.edu).

PURPOSE: To evaluate a high-spatial-resolution three-dimensional (3D) contrast material–enhanced magnetic resonance (MR) angiographic technique for detecting proximal and distal renal arterial stenosis.

MATERIALS AND METHODS: Twenty-five patients underwent high-spatial-resolution small–field-of-view (FOV) 3D contrast-enhanced MR angiography of the renal arteries, which was followed several minutes later by more standard, large-FOV 3D contrast-enhanced MR angiography that included the distal aorta and iliac arteries. For both acquisitions, MR fluoroscopic triggering and an elliptic centric view order were used. Two readers evaluated the MR angiograms for grade and hemodynamic significance of renal arterial stenosis, diagnostic quality, and presence of artifacts. MR imaging results for each patient were compared with those of digital subtraction angiograms.

RESULTS: The high-spatial-resolution small-FOV technique provided high sensitivity (97%) and specificity (92%) for the detection of renal arterial stenosis, including all four distal stenoses encountered. The portrayal of the segmental renal arteries was adequate for diagnosis in 19 (76%) of 25 patients. In 12% of the patients, impaired depiction of the segmental arteries was linked to motion.

CONCLUSION: The combined high-spatial-resolution small-FOV and large-FOV MR angiographic examination provides improved spatial resolution in the region of the renal arteries while maintaining coverage of the abdominal aorta and iliac arteries.

Index terms: Magnetic resonance (MR), contrast media, 96.12943 • Magnetic resonance (MR), rapid imaging, 96.12942, 96.12943 • Magnetic resonance (MR), vascular studies, 96.12942 • Renal angiography, 96.122, 96.12942 • Renal arteries, MR, 96.12942, 96.12943 • Renal arteries, stenosis or obstruction, 96.721

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