HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mallouhi, A. Articles by Jaschke, W. R. Search for Related Content PubMed PubMed Citation Articles by Mallouhi, A. Articles by Jaschke, W. R.

3D MR Angiography of Renal Arteries: Comparison of Volume Rendering and Maximum Intensity Projection Algorithms¹

¹ From the Department of Radiology, Innsbruck University Hospital, Anichstrasse 35, 6020 Innsbruck, Austria. From the 2000 RSNA scientific assembly. Received April 30, 2001; revision requested May 25; revision received August 9; accepted September 28. Address correspondence to A.M. (e-mail: ammar.mallouhi@uibk.ac.at).

View larger version (27K): [in a new window]   Figure 1a. Graph shows linear regression analysis of mean percentages of renal artery stenosis, as measured by using MIP (x, dashed line) and VR (, solid line) plotted against DSA. Dotted line indicates perfect agreement of MR angiography and DSA. (a) Graph shows a positive and high correlation with DSA for MIP (r2 = 0.83, P < .001) and VR (r2 = 0.96, P < .001) when all arteries were considered. (b) By using a cutoff of 50% stenosis, correlation between MIP and DSA decreases substantially (r2 = 0.38, P = .001), with no considerable change in the relationship between VR and DSA (r2 = 0.84, P < .001). (c) By using a cutoff of 70% stenosis, graph shows there is no statistically significant correlation between MIP and DSA (r2 = 0.21, P = .1), whereas a significant relationship (r2 = 0.83, P < .001) between VR and DSA was maintained.

View larger version (27K): [in a new window]   Figure 1b. Graph shows linear regression analysis of mean percentages of renal artery stenosis, as measured by using MIP (x, dashed line) and VR (, solid line) plotted against DSA. Dotted line indicates perfect agreement of MR angiography and DSA. (a) Graph shows a positive and high correlation with DSA for MIP (r2 = 0.83, P < .001) and VR (r2 = 0.96, P < .001) when all arteries were considered. (b) By using a cutoff of 50% stenosis, correlation between MIP and DSA decreases substantially (r2 = 0.38, P = .001), with no considerable change in the relationship between VR and DSA (r2 = 0.84, P < .001). (c) By using a cutoff of 70% stenosis, graph shows there is no statistically significant correlation between MIP and DSA (r2 = 0.21, P = .1), whereas a significant relationship (r2 = 0.83, P < .001) between VR and DSA was maintained.

View larger version (24K): [in a new window]   Figure 1c. Graph shows linear regression analysis of mean percentages of renal artery stenosis, as measured by using MIP (x, dashed line) and VR (, solid line) plotted against DSA. Dotted line indicates perfect agreement of MR angiography and DSA. (a) Graph shows a positive and high correlation with DSA for MIP (r2 = 0.83, P < .001) and VR (r2 = 0.96, P < .001) when all arteries were considered. (b) By using a cutoff of 50% stenosis, correlation between MIP and DSA decreases substantially (r2 = 0.38, P = .001), with no considerable change in the relationship between VR and DSA (r2 = 0.84, P < .001). (c) By using a cutoff of 70% stenosis, graph shows there is no statistically significant correlation between MIP and DSA (r2 = 0.21, P = .1), whereas a significant relationship (r2 = 0.83, P < .001) between VR and DSA was maintained.

View larger version (142K): [in a new window]   Figure 2a. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (3.2/1.2, 30° flip angle) in a 57-year-old woman with hypertension. (a) Coronal oblique subvolume MIP image shows a truncal mild (40%) stenosis (arrow) of the left main renal artery. (b) Transverse oblique subvolume MIP image shows a truncal moderate (60%) stenosis (arrow) of the left main renal artery. Combination of findings on both MIP images indicated a moderate (50%) stenosis. (c) Coronal oblique anteroposterior view on VR image shows a normal left main renal artery (arrow) and a normal lower pole left accessory artery (arrowhead). (d) transverse oblique VR image depicts a mild (10%) stenosis (arrow) of the renal artery. Combination of findings on both VR images indicated a normal renal artery. (e) Left oblique intraarterial DSA image shows no stenosis of the left main and accessory renal arteries. Intraarterial blood pressure measurements revealed no gradient between the aorta and renal artery and thus ruled out the moderate stenosis depicted in b.

View larger version (111K): [in a new window]   Figure 2b. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (3.2/1.2, 30° flip angle) in a 57-year-old woman with hypertension. (a) Coronal oblique subvolume MIP image shows a truncal mild (40%) stenosis (arrow) of the left main renal artery. (b) Transverse oblique subvolume MIP image shows a truncal moderate (60%) stenosis (arrow) of the left main renal artery. Combination of findings on both MIP images indicated a moderate (50%) stenosis. (c) Coronal oblique anteroposterior view on VR image shows a normal left main renal artery (arrow) and a normal lower pole left accessory artery (arrowhead). (d) transverse oblique VR image depicts a mild (10%) stenosis (arrow) of the renal artery. Combination of findings on both VR images indicated a normal renal artery. (e) Left oblique intraarterial DSA image shows no stenosis of the left main and accessory renal arteries. Intraarterial blood pressure measurements revealed no gradient between the aorta and renal artery and thus ruled out the moderate stenosis depicted in b.

View larger version (156K): [in a new window]   Figure 2c. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (3.2/1.2, 30° flip angle) in a 57-year-old woman with hypertension. (a) Coronal oblique subvolume MIP image shows a truncal mild (40%) stenosis (arrow) of the left main renal artery. (b) Transverse oblique subvolume MIP image shows a truncal moderate (60%) stenosis (arrow) of the left main renal artery. Combination of findings on both MIP images indicated a moderate (50%) stenosis. (c) Coronal oblique anteroposterior view on VR image shows a normal left main renal artery (arrow) and a normal lower pole left accessory artery (arrowhead). (d) transverse oblique VR image depicts a mild (10%) stenosis (arrow) of the renal artery. Combination of findings on both VR images indicated a normal renal artery. (e) Left oblique intraarterial DSA image shows no stenosis of the left main and accessory renal arteries. Intraarterial blood pressure measurements revealed no gradient between the aorta and renal artery and thus ruled out the moderate stenosis depicted in b.

View larger version (90K): [in a new window]   Figure 2d. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (3.2/1.2, 30° flip angle) in a 57-year-old woman with hypertension. (a) Coronal oblique subvolume MIP image shows a truncal mild (40%) stenosis (arrow) of the left main renal artery. (b) Transverse oblique subvolume MIP image shows a truncal moderate (60%) stenosis (arrow) of the left main renal artery. Combination of findings on both MIP images indicated a moderate (50%) stenosis. (c) Coronal oblique anteroposterior view on VR image shows a normal left main renal artery (arrow) and a normal lower pole left accessory artery (arrowhead). (d) transverse oblique VR image depicts a mild (10%) stenosis (arrow) of the renal artery. Combination of findings on both VR images indicated a normal renal artery. (e) Left oblique intraarterial DSA image shows no stenosis of the left main and accessory renal arteries. Intraarterial blood pressure measurements revealed no gradient between the aorta and renal artery and thus ruled out the moderate stenosis depicted in b.

View larger version (164K): [in a new window]   Figure 2e. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (3.2/1.2, 30° flip angle) in a 57-year-old woman with hypertension. (a) Coronal oblique subvolume MIP image shows a truncal mild (40%) stenosis (arrow) of the left main renal artery. (b) Transverse oblique subvolume MIP image shows a truncal moderate (60%) stenosis (arrow) of the left main renal artery. Combination of findings on both MIP images indicated a moderate (50%) stenosis. (c) Coronal oblique anteroposterior view on VR image shows a normal left main renal artery (arrow) and a normal lower pole left accessory artery (arrowhead). (d) transverse oblique VR image depicts a mild (10%) stenosis (arrow) of the renal artery. Combination of findings on both VR images indicated a normal renal artery. (e) Left oblique intraarterial DSA image shows no stenosis of the left main and accessory renal arteries. Intraarterial blood pressure measurements revealed no gradient between the aorta and renal artery and thus ruled out the moderate stenosis depicted in b.

View larger version (174K): [in a new window]   Figure 3a. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (4.6/1.8, 30° flip angle) in a 79-year-old woman with bilateral renal artery stenosis. (a) Coronal oblique anteroposterior subvolume MIP image shows a severe (80%) truncal stenosis (arrow) of the left main renal artery. Combining findings on transverse MIP image (not shown), which revealed an 80% stenosis, with findings on coronal MIP image resulted in an overall stenosis severity of 80%. (b) Coronal oblique posteroanterior VR image depicts a moderate (50%) truncal stenosis (arrow) of the left renal artery. Combining findings on transverse VR image (not shown), which revealed a 70% stenosis, with findings on coronal VR image resulted in an overall stenosis severity of 60%. The delineation of the stenotic segment on the VR view is superior to that on the MIP image. (c) Anteroposterior intraarterial DSA image confirms the stenosis severity measured on VR view and shows a small lower pole left accessory artery (arrowheads). (d) Coronal oblique subvolume MIP and (e) anteroposterior VR images depict the accessory left renal artery (arrowheads). Because of interactive reconstructions, evaluation of the main, accessory, and segmental left renal arteries on VR views was not substantially hampered by the considerable enhancement of the left renal vein.

View larger version (137K): [in a new window]   Figure 3b. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (4.6/1.8, 30° flip angle) in a 79-year-old woman with bilateral renal artery stenosis. (a) Coronal oblique anteroposterior subvolume MIP image shows a severe (80%) truncal stenosis (arrow) of the left main renal artery. Combining findings on transverse MIP image (not shown), which revealed an 80% stenosis, with findings on coronal MIP image resulted in an overall stenosis severity of 80%. (b) Coronal oblique posteroanterior VR image depicts a moderate (50%) truncal stenosis (arrow) of the left renal artery. Combining findings on transverse VR image (not shown), which revealed a 70% stenosis, with findings on coronal VR image resulted in an overall stenosis severity of 60%. The delineation of the stenotic segment on the VR view is superior to that on the MIP image. (c) Anteroposterior intraarterial DSA image confirms the stenosis severity measured on VR view and shows a small lower pole left accessory artery (arrowheads). (d) Coronal oblique subvolume MIP and (e) anteroposterior VR images depict the accessory left renal artery (arrowheads). Because of interactive reconstructions, evaluation of the main, accessory, and segmental left renal arteries on VR views was not substantially hampered by the considerable enhancement of the left renal vein.

View larger version (162K): [in a new window]   Figure 3c. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (4.6/1.8, 30° flip angle) in a 79-year-old woman with bilateral renal artery stenosis. (a) Coronal oblique anteroposterior subvolume MIP image shows a severe (80%) truncal stenosis (arrow) of the left main renal artery. Combining findings on transverse MIP image (not shown), which revealed an 80% stenosis, with findings on coronal MIP image resulted in an overall stenosis severity of 80%. (b) Coronal oblique posteroanterior VR image depicts a moderate (50%) truncal stenosis (arrow) of the left renal artery. Combining findings on transverse VR image (not shown), which revealed a 70% stenosis, with findings on coronal VR image resulted in an overall stenosis severity of 60%. The delineation of the stenotic segment on the VR view is superior to that on the MIP image. (c) Anteroposterior intraarterial DSA image confirms the stenosis severity measured on VR view and shows a small lower pole left accessory artery (arrowheads). (d) Coronal oblique subvolume MIP and (e) anteroposterior VR images depict the accessory left renal artery (arrowheads). Because of interactive reconstructions, evaluation of the main, accessory, and segmental left renal arteries on VR views was not substantially hampered by the considerable enhancement of the left renal vein.

View larger version (164K): [in a new window]   Figure 3d. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (4.6/1.8, 30° flip angle) in a 79-year-old woman with bilateral renal artery stenosis. (a) Coronal oblique anteroposterior subvolume MIP image shows a severe (80%) truncal stenosis (arrow) of the left main renal artery. Combining findings on transverse MIP image (not shown), which revealed an 80% stenosis, with findings on coronal MIP image resulted in an overall stenosis severity of 80%. (b) Coronal oblique posteroanterior VR image depicts a moderate (50%) truncal stenosis (arrow) of the left renal artery. Combining findings on transverse VR image (not shown), which revealed a 70% stenosis, with findings on coronal VR image resulted in an overall stenosis severity of 60%. The delineation of the stenotic segment on the VR view is superior to that on the MIP image. (c) Anteroposterior intraarterial DSA image confirms the stenosis severity measured on VR view and shows a small lower pole left accessory artery (arrowheads). (d) Coronal oblique subvolume MIP and (e) anteroposterior VR images depict the accessory left renal artery (arrowheads). Because of interactive reconstructions, evaluation of the main, accessory, and segmental left renal arteries on VR views was not substantially hampered by the considerable enhancement of the left renal vein.

View larger version (140K): [in a new window]   Figure 3e. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (4.6/1.8, 30° flip angle) in a 79-year-old woman with bilateral renal artery stenosis. (a) Coronal oblique anteroposterior subvolume MIP image shows a severe (80%) truncal stenosis (arrow) of the left main renal artery. Combining findings on transverse MIP image (not shown), which revealed an 80% stenosis, with findings on coronal MIP image resulted in an overall stenosis severity of 80%. (b) Coronal oblique posteroanterior VR image depicts a moderate (50%) truncal stenosis (arrow) of the left renal artery. Combining findings on transverse VR image (not shown), which revealed a 70% stenosis, with findings on coronal VR image resulted in an overall stenosis severity of 60%. The delineation of the stenotic segment on the VR view is superior to that on the MIP image. (c) Anteroposterior intraarterial DSA image confirms the stenosis severity measured on VR view and shows a small lower pole left accessory artery (arrowheads). (d) Coronal oblique subvolume MIP and (e) anteroposterior VR images depict the accessory left renal artery (arrowheads). Because of interactive reconstructions, evaluation of the main, accessory, and segmental left renal arteries on VR views was not substantially hampered by the considerable enhancement of the left renal vein.

View larger version (138K): [in a new window]   Figure 4a. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (3.2/1.2, 30° flip angle) in a 50-year-old woman with bilateral renal artery stenosis and atrophied right kidney. (a) Coronal oblique subvolume MIP image shows a severe (95%) ostial stenosis (solid arrow) of the right renal artery with a poststenotic dilatation. The stenotic segment simulates occlusion. Combining findings on transverse MIP image (not shown), which revealed a 95% stenosis, with findings on coronal MIP image resulted in an overall stenosis severity of 95%. (b) Coronal oblique VR view depicts, in contrast to the MIP image, the fine residual lumen of the right renal artery severe (90%) stenosis (solid arrow). Combining findings on transverse VR image (not shown), which revealed a 90% stenosis, with findings on coronal VR image resulted in an overall stenosis severity of 90%. MIP and VR images depict a mild proximal stenosis of the left renal artery (open arrow) confirmed at DSA (image not shown). (c) Right oblique selective DSA image confirms the stenosis severity.

View larger version (110K): [in a new window]   Figure 4b. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (3.2/1.2, 30° flip angle) in a 50-year-old woman with bilateral renal artery stenosis and atrophied right kidney. (a) Coronal oblique subvolume MIP image shows a severe (95%) ostial stenosis (solid arrow) of the right renal artery with a poststenotic dilatation. The stenotic segment simulates occlusion. Combining findings on transverse MIP image (not shown), which revealed a 95% stenosis, with findings on coronal MIP image resulted in an overall stenosis severity of 95%. (b) Coronal oblique VR view depicts, in contrast to the MIP image, the fine residual lumen of the right renal artery severe (90%) stenosis (solid arrow). Combining findings on transverse VR image (not shown), which revealed a 90% stenosis, with findings on coronal VR image resulted in an overall stenosis severity of 90%. MIP and VR images depict a mild proximal stenosis of the left renal artery (open arrow) confirmed at DSA (image not shown). (c) Right oblique selective DSA image confirms the stenosis severity.

View larger version (159K): [in a new window]   Figure 4c. MIP and VR images from 3D MR angiography after administration of gadopentetate dimeglumine (3.2/1.2, 30° flip angle) in a 50-year-old woman with bilateral renal artery stenosis and atrophied right kidney. (a) Coronal oblique subvolume MIP image shows a severe (95%) ostial stenosis (solid arrow) of the right renal artery with a poststenotic dilatation. The stenotic segment simulates occlusion. Combining findings on transverse MIP image (not shown), which revealed a 95% stenosis, with findings on coronal MIP image resulted in an overall stenosis severity of 95%. (b) Coronal oblique VR view depicts, in contrast to the MIP image, the fine residual lumen of the right renal artery severe (90%) stenosis (solid arrow). Combining findings on transverse VR image (not shown), which revealed a 90% stenosis, with findings on coronal VR image resulted in an overall stenosis severity of 90%. MIP and VR images depict a mild proximal stenosis of the left renal artery (open arrow) confirmed at DSA (image not shown). (c) Right oblique selective DSA image confirms the stenosis severity.