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Steady‐state free precession MRA of the renal arteries: Breath‐hold and navigator‐gated techniques vs. CE‐MRA
Author(s) -
Maki Jeffrey H.,
Wilson Gregory J.,
Eubank William B.,
Glickerman David J.,
Pipavath Sudhakar,
Hoogeveen Romhild M.
Publication year - 2007
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/jmri.21134
Subject(s) - steady state free precession imaging , medicine , stenosis , magnetic resonance angiography , radiology , nuclear medicine , receiver operating characteristic , renal artery stenosis , renal artery , magnetic resonance imaging , kidney
Purpose To explore the use of breath‐hold and navigator‐gated noncontrast Steady State Free Precession (SSFP) MR angiography (MRA) protocols for the evaluation of renal artery stenosis (RAS). Materials and Methods Twenty patients referred to rule out RAS were imaged using two breath‐hold and one navigator‐gated SSFP MRA sequences. All patients underwent contrast‐enhanced MRA (CE‐MRA). Two radiologists evaluated all sequences both qualitatively (blur, artifacts, reader confidence) and quantitatively (maximum stenosis). Using CE‐MRA as truth, a receiver operating characteristics (ROC) curve was generated and a statistical analysis of navigator‐gated SSFP (Nav SSFP) was performed. Results Seven patients had >50% renal artery stenosis by CE‐MRA. Nav SSFP performed significantly better than either breath‐hold SSFP technique in terms of blur, artifacts, and reader confidence. Using a 50% threshold for stenosis, sensitivity for detecting RAS was 100%, with a specificity of 85% and a negative predictive value of 100%. The average mean stenosis difference between Nav SSFP and CE‐MRA was 9 ± 9%. Conclusion Nav SSFP outperformed breath‐hold SSFP in measures of image quality and reader confidence. Sensitivity and negative predictive value for detecting RAS with Nav SSFP was perfect, with an acceptable specificity of 85%. This suggests further study is warranted to evaluate Nav SSFP as a noncontrast screening technique for renal artery stenosis. J. Magn. Reson. Imaging 2007;26:966–973. © 2007 Wiley‐Liss, Inc.