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Phase Contrast Magnetic Resonance Imaging in the Rat Common Carotid Artery
Published on: September 5, 2018
Non-contrast renal artery MRA using an inflow inversion recovery steady state free precession technique (Inhance):
James F Glockner1, Naoki Takahashi, Akira Kawashima
1Mayo Clinic, Rochester, Minnesota 55905, USA. Glockner.james@mayo.edu
Purpose:
To assess the performance of a three-dimensional (3D) non-contrast respiratory-triggered steady state free precession (SSFP) pulse sequence for detection of renal artery stenosis.
Materials And Methods:
A total of 64 patients who had non-contrast MR angiography (NC MRA) and 3D contrast-enhanced MRA (CE MRA) performed during the same exam and three patients who had NC MRA followed by conventional catheter angiography within one month of the MRI exam were included in this retrospective study. Two blinded readers evaluated NC MRA images for the presence of significant renal artery stenosis and also rated their diagnostic confidence and evaluated the images for artifact. A similar analysis was performed for CE MRA images by two additional blinded readers, and discrepancies were resolved by consensus reading.
Results:
The 67 patients had 168 main and accessory renal arteries, with significant (>50%) stenosis in 34 arteries on CE MRA or conventional angiography. The two NC MRA readers had sensitivity and specificity for detection of significant stenosis of 94%/82% and 82%/87% respectively on a per renal artery basis.
Conclusion:
There was good agreement between CE MRA and NC MRA for detection of significant renal artery stenosis. This technique should prove useful in evaluating patients with suspected renovascular hypertension who are unable to undergo CE MRA.
Insights
Non-contrast MR angiography (NC MRA) effectively detects renal artery stenosis, showing good agreement with contrast-enhanced MRA. This technique is valuable for patients unable to undergo contrast-enhanced MRA.
Area of Science:
- Radiology
- Medical Imaging
- Cardiovascular Imaging
Background:
- Renal artery stenosis (RAS) is a significant cause of renovascular hypertension.
- Contrast-enhanced MR angiography (CE MRA) is a common diagnostic tool for RAS.
- Patient contraindications or allergies may limit the use of contrast agents.
Purpose of the Study:
- To evaluate the diagnostic performance of a 3D non-contrast respiratory-triggered steady state free precession (SSFP) pulse sequence for detecting significant renal artery stenosis.
- To compare the accuracy of non-contrast MR angiography (NC MRA) with contrast-enhanced MR angiography (CE MRA) and conventional angiography.
Main Methods:
- Retrospective analysis of 67 patients undergoing both NC MRA and CE MRA or conventional angiography.
- Two blinded readers assessed NC MRA images for significant RAS (>50%) and diagnostic confidence.
- CE MRA images were evaluated by two additional blinded readers, with discrepancies resolved by consensus.
Main Results:
- Out of 168 renal arteries, 34 showed significant stenosis.
- NC MRA demonstrated high sensitivity (94% and 82%) and specificity (82% and 87%) for detecting significant stenosis on a per-artery basis.
- Good agreement was observed between NC MRA and CE MRA in identifying significant RAS.
Conclusions:
- 3D non-contrast SSFP MR angiography is a reliable method for detecting significant renal artery stenosis.
- NC MRA offers a valuable alternative for patients who cannot undergo CE MRA, particularly those with suspected renovascular hypertension.
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