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Abstract
PURPOSE OF REVIEW During the last decade, several case series and small reports have indicated that pulmonary vein isolation (PVI) in combination with renal denervation (RDN) may increase the rate of atrial fibrillation (AF) freedom in patients with hypertension. We aimed to provide a contemporary systematic overview on the techniques, and the efficacy/safety of RDN on AF recurrence, and the current landscape of ongoing investigation. RECENT FINDINGS The recent Evaluate Renal Denervation in Addition to Catheter Ablation to Eliminate Atrial Fibrillation (ERADICATE-AF) trial has demonstrated convincingly that among patients with paroxysmal AF and poorly controlled (but not "resistant") hypertension, RDN added to catheter ablation, compared with catheter ablation alone, significantly increased the likelihood of freedom from AF at 12 months. RDN has proven to be a unique, effective and safe interventional therapy for the management of AF. Future investigation will likely focus on confirming current findings; expanding the population of eligible patients (eg., non-hypertensives, well controlled hypertensives); determining long-term maintenance of effect and therapeutics.
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Affiliation(s)
- Arwa Younis
- Clinical Cardiovascular Research Center, University of Rochester School of Medicine and Dentistry, 85 Woodland Road, Short Hills, NJ, 07078, USA
| | - Jonathan S Steinberg
- Clinical Cardiovascular Research Center, University of Rochester School of Medicine and Dentistry, 85 Woodland Road, Short Hills, NJ, 07078, USA.
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AbdelGawad EA, AbdelGawad EA, Magdi M. Reliability of ADC values in recognition of renal changes produced by extracorporeal shock wave lithotripsy (ESWL). THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018. [DOI: 10.1016/j.ejrnm.2017.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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3
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Lalude OO, Lerakis S. Cardiovascular Magnetic Resonance Imaging. Interv Cardiol 2016. [DOI: 10.1002/9781118983652.ch10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Stamatios Lerakis
- Emory University School of Medicine and Georgia Institute of Technology; Atlanta GA USA
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Affiliation(s)
- Jane Belfield
- Department of Radiology, Royal Liverpool University Hospital, Liverpool, UK.
| | - Steven Kennish
- Department of Radiology, Royal Hallamshire Hospital, Sheffield, UK
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Hocaoglu E, Inci E, Aydin S, Cesme DH, Kalfazade N. Is quantitative diffusion-weighted MRI a valuable technique for the detection of changes in kidneys after extracorporeal shock wave lithotripsy? Int Braz J Urol 2015; 41:139-46. [PMID: 25928520 PMCID: PMC4752067 DOI: 10.1590/s1677-5538.ibju.2015.01.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 06/30/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the capability and the reliability of diffusion-weighted imaging (DWI) in the changes of kidneys occurring after extracorporeal shock wave lithotripsy (ESWL) treatment for renal stones. MATERIALS AND METHODS A total of 32 patients who underwent ESWL treatment for renal stone disease between June and December 2011 were enrolled in this prospective study. Color Doppler ultrasonography (CDUS) and DWI were performed before and within 24 hours after ESWL. DWI was obtained with b factors of 0, 500 and 1000 s/ mm2 at 1.5 T MRI. Each of Resistive index (RI) and ADC values were calculated from the three regions of renal upper, middle and lower zones for both of the affected and contralateral kidneys. Paired sample t test was used for statistical analyses. RESULTS After ESWL, the treated kidneys had statistically significant lower ADC values in all different regions compared with previous renal images. The best discriminative parameter was signal intensity with a b value of 1000 s/mm2. The changes of DWI after ESWL were noteworthy in the middle of the treated kidney (p < 0.01). There were no significant difference between RI values in all regions of treated and contralateral kidneys before and after treatment with ESWL (p>0.05). CONCLUSION DWI is a valuable technique enables the detection of changes in DWI after ESWL treatment that may provide useful information in prediction of renal damage by shock waves, even CDUS is normal.
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Affiliation(s)
- Elif Hocaoglu
- Department of Radiology, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Ercan Inci
- Department of Radiology, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Sibel Aydin
- Department of Radiology, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Dilek Hacer Cesme
- Department of Radiology, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Nadir Kalfazade
- Department of Urology, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
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Ismaeel MM, Abdel-Hamid A. Role of high resolution contrast-enhanced magnetic resonance angiography (HR CeMRA) in management of arterial complications of the renal transplant. Eur J Radiol 2011; 79:e122-7. [PMID: 21601400 DOI: 10.1016/j.ejrad.2011.04.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 04/11/2011] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Transplant renal artery (RA) stenosis (TRAS) is the most frequent posttransplantation vascular complication. Contrast enhanced magnetic resonance (CeMRA) angiography has been established as the preferred imaging technique for the evaluation of TRAS because it does not require the use of iodinated contrast material and does not expose the patient to ionizing radiation. Digital subtraction angiography (DSA) is the gold standard in the evaluation of arterial tree of the renal allograft. AIM OF THE WORK This study was carried out to assess the accuracy of CeMRA in the detection of arterial complications after renal transplantation. PATIENTS AND METHODS Thirty renal transplant patients with suspected arterial complications in which both CeMRA and DSA were performed were included in the study. The HR CeMRA shows 93.7% sensitivity, 80% specificity, 88.2% positive predictive value, 88.9% negative predictive value and 88.5% accuracy. CONCLUSION HR CeMRA is an accurate reliable tool in the assessment of arterial complications after renal transplantation. It may replace DSA as a diagnostic modality with reservation of interventional techniques for endovascular treatment of suitable cases.
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Elsayes KM, Menias CO, Willatt J, Azar S, Harvin HJ, Platt JF. Imaging of Renal Transplant: Utility and Spectrum of Diagnostic Findings. Curr Probl Diagn Radiol 2011; 40:127-39. [DOI: 10.1067/j.cpradiol.2010.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Kramer U, Fenchel M, Laub G, Seeger A, Klumpp B, Bretschneider C, Finn JP, Claussen CD, Miller S. Low-dose, time-resolved, contrast-enhanced 3D MR angiography in the assessment of the abdominal aorta and its major branches at 3 Tesla. Acad Radiol 2010; 17:564-76. [PMID: 20171907 DOI: 10.1016/j.acra.2009.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Revised: 12/08/2009] [Accepted: 12/09/2009] [Indexed: 10/19/2022]
Abstract
RATIONALE AND OBJECTIVES The aims of this study were to evaluate the effectiveness of low-dose, contrast-enhanced (CE), time-resolved, three-dimensional magnetic resonance angiography (MRA) in the assessment of the abdominal aorta and its major branches at 3 T and to compare the results with those of high-spatial resolution CE MRA. MATERIALS AND METHODS Twenty-two consecutive patients (eight men, 14 women; mean age, 43.9 +/- 17.9 years) underwent CE time-resolved three-dimensional MRA and high-spatial resolution three-dimensional MRA. Studies were performed using a 3-T magnetic resonance system; gadolinium-based contrast medium was administered at a dose of 3 to 5 mL for time-resolved MRA, followed by 0.1 mmol/kg gadopentetate dimeglumine for single-phase CE MRA. For analysis purposes, the abdominal arterial system was divided into 11 arterial segments, and image quality as well as the presence and degree of vascular pathology were evaluated by two independent magnetic resonance radiologists. RESULTS A total of 242 arterial segments were visualized with good image quality. Time-resolved MRA was able to visualize the majority of arterial segments with good definition in the diagnostic range. Vascular pathologies (stenosis, occlusion) or abnormal vascular anatomy was detected in 19 arterial segments, with good interobserver agreement (kappa = 0.78). All image findings were detected with time-resolved CE MRA by both observers and were confirmed by correlative imaging. CONCLUSION Low-dose, time-resolved MRA at 3 T yields rapid and important anatomic and functional information in the evaluation of the abdominal vasculature. Because of its limited spatial resolution, time-resolved MRA is inferior to CE MRA in demonstrating fine vascular details.
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Eisenberger U, Thoeny HC, Binser T, Gugger M, Frey FJ, Boesch C, Vermathen P. Evaluation of renal allograft function early after transplantation with diffusion-weighted MR imaging. Eur Radiol 2009; 20:1374-83. [PMID: 20013274 DOI: 10.1007/s00330-009-1679-9] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Revised: 08/31/2009] [Accepted: 09/17/2009] [Indexed: 01/01/2023]
Abstract
AIMS To determine the inter-patient variability of apparent diffusion coefficients (ADC) and concurrent micro-circulation contributions from diffusion-weighted MR imaging (DW-MRI) in renal allografts early after transplantation, and to obtain initial information on whether these measures are altered in histologically proven acute allograft rejection (AR). METHODS DW-MRI was performed in 15 renal allograft recipients 5-19 days after transplantation. Four patients presented with AR and one with acute tubular necrosis (ATN). Total ADC (ADC(T)) was determined, which includes diffusion and micro-circulation contributions. Furthermore, diffusion and micro-circulation contributions were separated, yielding the "perfusion fraction" (F(P)), and "perfusion-free" diffusion (ADC(D)). RESULTS Diffusion parameters in the ten allografts with stable function early after transplantation demonstrated low variabilities. Values for ADC(T) and ADC(D) were (x10(-5) mm(2)/s) 228 +/- 14 and 203 +/- 9, respectively, in cortex and 226 +/- 16 and 199 +/- 9, respectively, in medulla. F(P) values were 18 +/- 5% in cortex and 19 +/- 5% in medulla. F(P) values were strongly reduced to less than 12% in cortex and medulla of renal transplants with AR and ATN. F(P) values correlated with creatinine clearance. CONCLUSION DW-MRI allows reliable determination of diffusion and micro-circulation contributions in renal allografts shortly after transplantation; deviations in AR indicate potential clinical utility of this method to non-invasively monitor derangements in renal allografts.
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Affiliation(s)
- Ute Eisenberger
- Department of Nephrology and Hypertension, University Hospital of Bern, Bern, Switzerland
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10
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Free-Breathing Accelerated Gadolinium-Enhanced MR Angiography in the Diagnosis of Renovascular Disease. AJR Am J Roentgenol 2009; 192:1531-7. [DOI: 10.2214/ajr.08.1559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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11
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Ciura VA, Lee MJ, Schemmer DC. MRA: Current Applications in Body Vascular Imaging. Can Assoc Radiol J 2009; 60:133-42. [DOI: 10.1016/j.carj.2009.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Viesha A. Ciura
- Department of Diagnostic Imaging, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Mark J. Lee
- Department of Diagnostic Imaging, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Drew C. Schemmer
- Department of Diagnostic Imaging, Foothills Medical Centre, Calgary, Alberta, Canada
- Department of Diagnostic Imaging, Royal Victoria Hospital, Barrie, Ontario, Canada
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Abstract
While nonenhanced magnetic resonance (MR) angiographic methods have been available since the earliest days of MR imaging, prolonged acquisition times and image artifacts have generally limited their use in favor of gadolinium-enhanced MR angiographic techniques. However, the combination of recent technical advances and new concerns about the safety of gadolinium-based contrast agents has spurred a resurgence of interest in methods that do not require exogenous contrast material. After a review of basic considerations in vascular imaging, the established methods for nonenhanced MR angiographic techniques, such as time of flight and phase contrast, are considered and their advantages and disadvantages are discussed. This article then focuses on new techniques that are becoming commercially available, such as electrocardiographically gated partial-Fourier fast spin-echo methods and balanced steady-state free precession imaging both with and without arterial spin labeling. Challenges facing these methods and possible solutions are considered. Since different imaging techniques rely on different mechanisms of image contrast, recommendations are offered for which strategies may work best for specific angiographic applications. Developments on the horizon include techniques that provide time-resolved imaging for assessment of flow dynamics by using nonenhanced approaches.
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Affiliation(s)
- Mitsue Miyazaki
- Department of MRI, Toshiba Medical Research Institute USA, 990 Corporate Woods Pkwy, Vernon Hills, IL 60061, USA.
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Prospective Comparison of Magnetic Resonance Angiography with Selective Renal Angiography for Living Kidney Donor Assessment. Urology 2008; 71:385-9. [DOI: 10.1016/j.urology.2007.10.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 09/14/2007] [Accepted: 10/19/2007] [Indexed: 11/19/2022]
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Abstract
Sonographic evaluation of the genitourinary system is a fast, safe, and effective means to detect renal disease. In conjunction with other modalities, Doppler can depict a variety of abnormalities. However, optimization of Doppler techniques and a solid understanding of Doppler threshold criteria are critical for success, whether in the native or transplanted kidney.
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Kramer U, Wiskirchen J, Fenchel MC, Seeger A, Laub G, Tepe G, Finn JP, Claussen CD, Miller S. Isotropic high-spatial-resolution contrast-enhanced 3.0-T MR angiography in patients suspected of having renal artery stenosis. Radiology 2008; 247:228-40. [PMID: 18270376 DOI: 10.1148/radiol.2471070565] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this study was to prospectively evaluate the diagnostic performance of contrast material-enhanced magnetic resonance (MR) angiography performed at 3 T for assessment of renal artery stenosis (RAS) by using parallel acquisition techniques with high acceleration factors and with digital subtraction angiography (DSA) as the reference standard. The study was institutional review board approved, and written informed consent was obtained from all patients. Twenty-nine patients (18 men, 11 women; mean age, 57.1 years +/- 14.3 [standard deviation]) suspected of having RAS underwent MR angiography. Images were evaluated qualitatively and quantitatively. The interobserver variability, sensitivity, specificity, and positive and negative predictive values of 3-T MR angiography, as compared with DSA (performed in 15 patients), were calculated. All examinations yielded good or excellent image quality. The sensitivity and specificity of MR angiography in grading significant (>75%) stenosis were 94% and 96%, respectively. Owing to its high sensitivity, contrast-enhanced 3-T MR angiography can be used reliably to exclude RAS and can serve as a useful screening method in the diagnostic work-up of patients with arterial hypertension.
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Affiliation(s)
- Ulrich Kramer
- Department of Diagnostic Radiology, University of Tuebingen, Hoppe-Seyler-Str 3, 72076 Tuebingen, Germany.
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Diffusion-weighted magnetic resonance imaging in the evaluation of renal function: A preliminary study. Radiol Med 2007; 112:1201-10. [DOI: 10.1007/s11547-007-0217-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Accepted: 08/30/2006] [Indexed: 10/22/2022]
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Preoperative Evaluation of Potential Living Related Kidney Donors with High-Spatial-Resolution Magnetic Resonance (MR) Angiography at 3 Tesla. Invest Radiol 2007; 42:747-55. [DOI: 10.1097/rli.0b013e31812dfb11] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nikken JJ, Krestin GP. MRI of the kidney-state of the art. Eur Radiol 2007; 17:2780-93. [PMID: 17646992 PMCID: PMC2039780 DOI: 10.1007/s00330-007-0701-3] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2006] [Revised: 04/25/2007] [Accepted: 05/10/2007] [Indexed: 01/12/2023]
Abstract
Ultrasound and computed tomography (CT) are modalities of first choice in renal imaging. Until now, magnetic resonance imaging (MRI) has mainly been used as a problem-solving technique. MRI has the advantage of superior soft-tissue contrast, which provides a powerful tool in the detection and characterization of renal lesions. The MRI features of common and less common renal lesions are discussed as well as the evaluation of the spread of malignant lesions and preoperative assessment. MR urography technique and applications are discussed as well as the role of MRI in the evaluation of potential kidney donors. Furthermore the advances in functional MRI of the kidney are highlighted.
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Affiliation(s)
- J J Nikken
- Department of Radiology, Erasmus MC, University Medical Center Rotterdam, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
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Morales Ramos DA, Albuquerque PAB, Carpineta L, Faingold R. Magnetic Resonance Imaging of the Urinary Tract in the Fetal and Pediatric Population. Curr Probl Diagn Radiol 2007; 36:153-63. [PMID: 17601535 DOI: 10.1067/j.cpradiol.2007.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Magnetic resonance imaging (MRI) has become an excellent modality for the assessment of renal pathologies in children; its multiplanar capability and soft-tissue contrast resolution allows for exquisite demonstration of the renal anatomy and its abnormalities. In this article, we illustrate and discuss MRI techniques and findings of the most commonly seen renal anomalies, including congenital, inflammatory, neoplastic, posttransplant, and miscellaneous conditions.
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Affiliation(s)
- D Alicia Morales Ramos
- Department of Medical Imaging, Montreal Children's Hospital/McGill University Health Centre, Montreal, PQ, Canada
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Browne RFJ, Tuite DJ. Imaging of the renal transplant: comparison of MRI with duplex sonography. ACTA ACUST UNITED AC 2007; 31:461-82. [PMID: 16447085 DOI: 10.1007/s00261-005-0394-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Renal transplantation is an established treatment for patients with end-stage renal disease. Many causes of graft dysfunction are treatable, making prompt detection and diagnosis of complications essential. Sensitive, noninvasive imaging procedures, which do not use iodinated contrast media, are therefore highly desirable to evaluate graft function. Duplex sonography (US) has traditionally been the initial investigation of graft dysfunction. US offers many advantages, particularly during the postoperative period, when it can be performed portably regardless of renal function and can guide percutaneous procedures. However, US lacks specificity in assessing hydronephrosis, cannot differentiate parenchymal causes of dysfunction, and may have difficulty assessing transplant vessels. Recently comprehensive magnetic resonance imaging (MRI) protocols including MR urography, gadolinium-enhanced MR angiography, and MR renography have evolved as a "one-stop" diagnostic technique in the evaluation of the entire graft and peritransplant region. Multiplanar capabilities enable MRI to identify the site of urinary obstruction and assess renal vessels in their entirety. The evolving technique of MR renography may also differentiate parenchymal causes of dysfunction. By combining these three components into a single examination, further information may be obtained regarding the graft when compared with US and other conventional studies, with improved patient convenience, less morbidity, and a potential cost saving.
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Affiliation(s)
- R F J Browne
- Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin, 24, Ireland.
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Nael K, Saleh R, Lee M, McNamara T, Godinez SR, Laub G, Finn JP, Ruehm SG. High-spatial-resolution contrast-enhanced MR angiography of abdominal arteries with parallel acquisition at 3.0 T: initial experience in 32 patients. AJR Am J Roentgenol 2006; 187:W77-85. [PMID: 16794143 DOI: 10.2214/ajr.05.1440] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The objective of our study was to evaluate an isotropic high-spatial-resolution 3D contrast-enhanced MR angiography (CE-MRA) protocol with high acceleration parallel acquisition at 3.0 T for the display of the abdominal vasculature. SUBJECTS AND METHODS Thirty-two consecutive patients (13 men, 19 women; age range, 28-88 years) with suspected abdominal arterial disease underwent abdominal 3D CE-MRA on a 3.0-T MR system, using a high-spatial-resolution (0.7 x 0.82 x 0.8 mm3) 3D gradient-refocused echo (GRE) sequence, integrated with a generalized autocalibrating partially parallel acquisitions (GRAPPA) technique with an acceleration factor of 3. Two vascular radiologists evaluated image quality and the presence and degree of arterial stenoses. Interobserver variability was calculated, using the kappa coefficient. The sensitivity and specificity of the technique were calculated and comparative analysis was performed with those of conventional catheter angiography (in eight patients) as the standard of reference. RESULTS The abdominal arterial vasculature was visualized with diagnostic image quality in all subjects. Arterial stenoses were detected in 148 and 142 arterial segments by observer 1 and observer 2, respectively, with good interobserver agreement (kappa = 0.75; 95% confidence interval [CI]: 0.69-0.81). The sensitivity and specificity values for CE-MRA for the detection of significant (> 50%) arterial stenoses were 100% and 96% for observer 1 and 100% and 92% for observer 2, respectively. There was a significant correlation between CE-MRA and conventional angiography (R = 0.96 and 0.93 for observers 1 and 2, respectively) for the assessment of the degree of stenosis. CONCLUSION The outlined MR angiography protocol at 3.0 T combined with parallel acquisition technique renders highly reliable and isotropic high-spatial-resolution imaging of the abdominal vasculature.
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Affiliation(s)
- Kambiz Nael
- Department of Radiology, David Geffen School of Medicine, University of California, Los Angeles, 10945 Le Conte Ave., Ste. 3371, Los Angeles, CA 90095, USA.
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El-Diasty TA, El-Ghar MEA, Shokeir AA, Gad HM, Wafa EW, El-Azab ME, El-Din ABS, Ghoneim MA. Magnetic resonance imaging as a sole method for the morphological and functional evaluation of live kidney donors. BJU Int 2005; 96:111-6. [PMID: 15963132 DOI: 10.1111/j.1464-410x.2005.05578.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate gadolinium-enhanced dynamic magnetic resonance imaging (MRI) as the sole method for the anatomical and functional assessment of potential live-kidney donors. SUBJECTS AND METHODS The study included 50 consecutive kidney donors; in addition to routine donor evaluation, the kidney was imaged with Gd-enhanced dynamic MRI, which was also used for selectively determining the glomerular filtration rate (GFR) of each kidney. All donors had a m99Tc-mercaptoacetyltriglycine (MAG3) renal scan as the reference standard to measure GFR. The anatomical results of MRI were compared with the findings at donor nephrectomy, and the GFR estimated from MRI compared with that from MAG3 scintigraphy. RESULTS MR angiography had 100% sensitivity, 94% specificity and 96% overall accuracy for detecting the number of renal arteries, and 100% sensitivity, 98% specificity and 98% overall accuracy for the number of renal veins. There was a close correlation (r = 0.54, P < 0.01) between the GFR of each kidney estimated by MRI or MAG3. For the right and left kidneys the mean isotope clearance was not significantly different from that of mean MRI clearance. MR urography allowed visualization of the urinary tract and the detection of any abnormality. CONCLUSION Gd-enhanced dynamic MRI can provide accurate information about the anatomy of the urinary tract and vasculature of the kidney, and can be used to accurately estimate the selective GFR of each kidney. Therefore, we recommend MRI as a single imaging diagnostic method for assessing potential live kidney donors.
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