Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul-Aug;53(4):229-235.
doi: 10.1590/0100-3984.2019.0013.

Unenhanced magnetic resonance angiography as an accurate alternative in the preoperative assessment of potential living kidney donors with contraindications to computed tomography angiography and to contrast-enhanced magnetic resonance angiography

Fernanda Garozzo Velloni  1   2 , Patrícia Prando Cardia  1   3 , Ulysses Dos Santos Torres  4 , Marco Antonio Haddad Pereira  1   2 , Thiago José Penachim  3 , Larissa Rossini Favaro  1 , Miguel Ramalho  5 , Giuseppe D'Ippolito  1   4
Affiliations

Unenhanced magnetic resonance angiography as an accurate alternative in the preoperative assessment of potential living kidney donors with contraindications to computed tomography angiography and to contrast-enhanced magnetic resonance angiography

Fernanda Garozzo Velloni et al. Radiol Bras. 2020 Jul-Aug.

Abstract
in English, Portuguese

Objective: To evaluate the accuracy of steady-state free precession (SSFP) unenhanced magnetic resonance angiography (MRA) at 1.5 T for the identification of multiple renal arteries, using computed tomography angiography (CTA) as the reference standard.

Materials and methods: This was a prospective study involving 39 patients (26 males; mean age, 62.6 years) who underwent CTA and unenhanced MRA to evaluate the proximal and middle segments of the renal arteries. The analysis was performed in two phases: the quality of unenhanced MRA images was classified as diagnostic or nondiagnostic for the presence of multiple renal arteries by two independent readers; two other independent readers then evaluated the images previously classified as being of diagnostic quality. The sensitivity, specificity, and overall accuracy of unenhanced MRA were calculated, CTA being used as the reference standard. The kappa statistic was used in order to calculate interobserver agreement.

Results: The image quality of unenhanced MRA was considered diagnostic in 70-90% of the extrarenal arterial segments. The CTA examination revealed 19 multiple renal arteries (8 on the right and 11 on the left). The accuracy of unenhanced MRA for the identification of multiple renal arteries was greater than 90%, with a sensitivity of 72.7-100% and a specificity of 96.3-100%.

Conclusion: Unenhanced MRA provides high quality imaging of the extrarenal segments of renal arteries. This method may be used as an alternative for the evaluation of the renal arteries, given that it has an accuracy comparable to that of CTA.

Objetivo: Avaliar, prospectivamente, a acurácia da angiografia por ressonância magnética (angio-RM) sem contraste, com a sequência steady-state free precession (SSFP) 1,5 T, para a identificação de artérias renais múltiplas, usando para isso a angiografia por tomografia computadorizada (angio-TC) como padrão de referência.

Materiais e métodos: Trinta e nove pacientes (26 do sexo masculino; idade média de 62,6 anos) foram submetidos a angio-TC e angio-RM para avaliação dos segmentos proximais e médios das artérias renais. A análise dividiu-se em duas partes: inicialmente, a qualidade das imagens de angio-RM foi classificada como diagnóstica ou não diagnóstica por dois avaliadores independentes; posteriormente, outros dois avaliadores analisaram as imagens consideradas diagnósticas quanto à presença de múltiplas artérias renais. Sensibilidade, especificidade e acurácia da angio-RM foram calculadas utilizando-se a angio-TC como referência. Estatística kappa foi utilizada para cálculo da concordância interobservador.

Resultados: A qualidade das imagens de angio-RM foi considerada diagnóstica em 70-90% dos segmentos arteriais extrarrenais. A angio-TC revelou 19 artérias renais múltiplas (8 direitas e 11 esquerdas). A acurácia da angio-RM para identificação de artérias renais múltiplas foi maior que 90%, com sensibilidade variando de 72,7% a 100% e especificidade variando de 96,3% a 100%.

Conclusão: A angio-RM sem contraste proporciona imagens de alta qualidade dos segmentos extrarrenais das artérias renais. Este método pode ser alternativamente utilizado para avaliação renal, com acurácia comparável à da angio-TC.

Keywords: Computed tomography angiography; Diagnostic techniques, urological; Kidney; Kidney transplantation; Magnetic resonance angiography.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Unenhanced MRA of renal arteries showing the coverage of the bSSFP sequence (focused on the renal artery plane, extending for 12 cm in the craniocaudal direction). MIP, maximum intensity projection.
Figure 2
Figure 2
Unenhanced MRA image demonstrating the segmentation of the renal arteries into the proximal segment (PS) and middle segment (MS).
Figure 3
Figure 3
Concordance between the two methods to evaluate the quality of the images. Axial CTA (A) and axial unenhanced MRA (B) images of the proximalsegment of the right renal artery (arrows) considered to be of diagnostic quality.
Figure 4
Figure 4
Multiple renal arteries. CTA (A) and unenhanced MRA (B), showing multiple renal arteries on the left (arrows).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • Cardiovascular Computed Tomography and Magnetic Resonance Imaging Guideline of the Brazilian Society of Cardiology and the Brazilian College of Radiology - 2024.
    Magalhães TA, Carneiro ACC, Moreira VM, Trad HS, Lopes MMU, Cerci RJ, Nacif MS, Schvartzman PR, Chagas ACP, Costa IBSDS, Schmidt A, Shiozaki AA, Montenegro ST, Piegas LS, Zapparoli M, Nicolau JC, Fernandes F, Hadlich MS, Ghorayeb N, Mesquita ET, Gonçalves LFG, Ramires FJA, Fernandes JL, Schwartzmann PV, Rassi S, Torreão JA, Mateos JCP, Beck-da-Silva L, Silva MC, Liberato G, Oliveira GMM, Feitosa Filho GS, Carvalho HDSM, Markman Filho B, Rocha RPS, Azevedo Filho CF, Taratsoutchi F, Coelho-Filho OR, Kalil Filho R, Hajjar LA, Ishikawa WY, Melo CA, Jatene IB, Albuquerque AS, Rimkus CM, Silva PSDD, Vieira TDR, Jatene FB, Azevedo GSAA, Santos RD, Monte GU, Ramires JAF, Bittencourt MS, Avezum A, Silva LSD, Abizaid A, Gottlieb I, Precoma DB, Szarf G, Sousa ACS, Pinto IMF, Medeiros FM, Caramelli B, Parga Filho JR, Santos TSGD, Prazeres CEED, Lopes MACQ, Avila LFR, Scanavacca MI, Gowdak LHW, Barberato SH, Nomura CH, Rochitte CE. Magalhães TA, et al. Arq Bras Cardiol. 2024 Oct 28;121(9):e20240608. doi: 10.36660/abc.20240608. Arq Bras Cardiol. 2024. PMID: 39475988 Free PMC article. English, Portuguese. No abstract available.

References

    1. Jha RC, Korangy SJ, Ascher SM, et al. MR angiography and preoperative evaluation for laparoscopic donor nephrectomy. AJR Am J Roentgenol. 2002;178:1489–1495. - PubMed
    1. Arévalo Pérez J, Gragera Torres F, Marín Toribio A, et al. Angio CT assessment of anatomical variants in renal vasculature: its importance in the living donor. Insights Imaging. 2013;4:199–211. - PMC - PubMed
    1. Laurence I, Ariff B, Quest RA, et al. Is there a role for free breathing non-contrast steady-state free precession renal MRA imaging for assessing live donors? A preliminary study. Br J Radiol. 2012;85:e448–e454. - PMC - PubMed
    1. Zhang HL, Sos TA, Winchester PA, et al. Renal artery stenosis: imaging options, pitfalls, and concerns. Prog Cardiovasc Dis. 2009;52:209–219. - PubMed
    1. Fraioli F, Catalano C, Bertoletti L, et al. Multidetector-row CT angiography of renal artery stenosis in 50 consecutive patients: prospective interobserver comparison with DSA. Radiol Med. 2006;111:459–468. - PubMed

LinkOut - more resources