Non-contrast-enhanced magnetic resonance angiography: a reliable clinical tool for evaluating transplant renal artery stenosis

• Published in: European radiology 2018-10, Vol.28 (10), p.4195-4204
• Main Authors: Zhang, Long Jiang, Peng, Jin, Wen, Jiqiu, Schoepf, U. Joseph, Varga-Szemes, Akos, Griffith, L. Parkwood, Yu, Yuan Meng, Tao, Shu Min, Li, Yan Jun, Ni, Xue Feng, Xu, Jian, Shi, Dong Hong, Lu, Guang Ming
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anatomy; Angiography; Angiography, Digital Subtraction; Arteries; Child; Complications; Diagnostic Radiology; Female; Humans; Image contrast; Image enhancement; Image quality; Imaging; Internal Medicine; Interventional Radiology; Kidney Transplantation; Kidney transplants; Magnetic resonance; Magnetic Resonance Angiography - methods; Magnetic resonance imaging; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Observer Variation; Patients; Postoperative Complications - diagnostic imaging; Postoperative Complications - pathology; Pseudoaneurysm; Quality assessment; Radiology; Renal artery; Renal Artery - diagnostic imaging; Renal Artery - pathology; Renal Artery Obstruction - diagnostic imaging; Renal Artery Obstruction - pathology; Reproducibility of Results; Resonance; Retrospective Studies; Stenosis; Ultrasound; Urogenital; Young Adult
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-018-5413-3

Purpose To evaluate image quality of non-contrast-enhanced magnetic resonance angiography (MRA) and compare transplant renal artery stenosis (TRAS) seen by non-contrast-enhanced MRA with digital subtraction angiography (DSA) as the gold standard. Materials and methods 330 patients receiving 369 non-contrast-enhanced MRA examinations from July 2014 to June 2017 were included. Thirty patients received at least two MRA examinations. Image quality was independently assessed by two radiologists. Inter-observer agreement was analyzed. Transplant renal artery anatomy and complications were evaluated and compared with DSA. If possible, accuracy was calculated on a per-artery basis. Results Good or excellent image quality was found in 95.4 % (352/369) of examinations with good inter-observer agreement (K=0.760). Twenty-two patients with DSA had 28 non-contrast-enhanced MRA examinations within a 2-month period. Of these, 19 patients had TRAS, two patients had pseudoaneurysms, and one patient had a normal transplant renal artery but an occluded external iliac artery. Non-contrast-enhanced MRA correctly detected 19 TRAS and nine normal arteries, giving 96.6 % accuracy on a per-artery basis. Conclusions Non-contrast-enhanced MRA demonstrates a good depiction of the transplanted renal artery and shows good correlation with DSA in cases where there was TRAS. Key Points • Good or excellent image quality was found in 95.4 % of examinations. • Non-contrast-enhanced MRA can clearly map transplant renal artery anatomy. • Non-contrast-enhanced MRA is a reliable tool to detect TRAS.