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Comprehensive MR evaluation of renovascular disease in five breath holds
Author(s) -
Schoenberg Stefan O.,
Essig Marco,
Bock Michael,
Hawighorst Hans,
Sharafuddin Melhem,
Knopp Michael V.
Publication year - 1999
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/(sici)1522-2586(199909)10:3<347::aid-jmri17>3.0.co;2-a
Subject(s) - medicine , renal artery stenosis , stenosis , renal artery , radiology , hemodynamics , fibromuscular dysplasia , cardiology , kidney
To detect a renal artery stenosis and assess its hemodynamic and functional significance in five breath holds. In a single MR exam, T1 weighted FLASH and T2 weighted fast spin echo techniques are used to assess renal morphology, multiphase 3D gadolinium (Gd) MRA to evaluate the renal arteries, and a segmented EPI cine phase‐contrast technique to measure renal artery blood flow. A standardized image analysis is performed to assess kidney size, corticomedullar differentiation (CMD), parenchymal enhancement, the degree of renal artery stenosis, abnormalities in blood flow pattern, and any associated abdominal vascular disease. Multiphase 3D‐Gd‐MRA accurately assesses atherosclerotic renal artery disease particularly in the presence of an associated aortic aneurysm. Delayed parenchymal enhancement, loss of CMD, and decrease in kidney size can be detected. In combination with decreased systolic velocity components, the diagnosis of a hemodynamically and functionally significant stenosis can be made. High‐resolution single‐phase 3D‐Gd‐MRA is preferable for evaluation of fibromuscular dysplasia or hypoplastic vessels. The combination of different breath hold techniques in a single, standardized MR exam allows to detect the hemodynamic and functional significance of a renal artery stenosis. J. Magn. Reson. Imaging 1999;10:347–356. © 1999 Wiley‐Liss, Inc.