Three-tesla MRI biphasic angiography: a method for preoperative assessment of the vascular supply in renal tumours—a surgical perspective

• Published in: World journal of urology 2013-10, Vol.31 (5), p.1171-1176
• Main Authors: Hora, Milan, Stránský, Petr, Trávníček, Ivan, Ürge, Tomáš, Eret, Viktor, Kreuzberg, Boris, Baxa, Jan, Mírka, Hynek, Petersson, Fredrik, Hes, Ondřej, Ferda, Jiří
• Format: Article
• Language: English
• Subjects: Humans; Imaging, Three-Dimensional; Kidney - blood supply; Kidney - diagnostic imaging; Kidney - pathology; Kidney Neoplasms - blood supply; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Laparoscopy - methods; Magnetic Resonance Angiography - methods; Medicine; Medicine & Public Health; Nephrectomy - methods; Nephrology; Oncology; Original Article; Preoperative Care - methods; Prospective Studies; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed; Urology
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-012-0870-9

Purpose The new generation of 3TMRI has improved spatial and time resolutions, which are favourable in imaging of the renal vasculature. In this study, we have compared the imaging findings of the renal blood vessels using 3TMRI and CT with intraoperative assessment of the renal vasculature as gold standard. Methods This prospective study was approved by the local ethical committee. Between 4/2011 and 12/2011, 80 patients with renal tumours underwent 3TMRA (angiography) (Magnetom SKYRA 3T, Siemens). Twenty of the patients were also examined with CT AG. The results of the CTA- and MRA-imaging studies were correlated with the intraoperative assessment of the renal vessels. Results Seventy patients (87.5 %) had a detailed intraoperative assessment of the renal vessels. The sensitivities for CTA and MRA were 88.2 and 88.6 %, respectively. All discrepancies between imaging studies and intraoperative findings were due to inability to identify small polar vessels. The results of MRA were concordant with CTA in 85.0 % of cases. The (three) discrepancies between MRI and CT were due to failure of MRI in identifying small polar vessels. Conclusions (1) 3TMRA gives detailed information about the renal vasculature including its topographical anatomy. (2) With MRI, small aberrant vessels are more frequently missed than with CTA. (3) CTA remains the gold standard. However, MRA may be used for planning of laparoscopic operations. (4) The quality of the 3D reconstruction is highly depending on the skills of the radiologist.