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Contrast enhanced MR angiography with parallel imaging in the early period after renal transplantation
Author(s) -
Gufler Hubert,
Weimer Wolfgang,
Neu Kathleen,
Wagner Sabine,
Rau Wigbert Stephan
Publication year - 2009
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.21726
Subject(s) - medicine , digital subtraction angiography , transplantation , anastomosis , angiography , stenosis , radiology , renal artery , kidney transplantation , renal artery stenosis , magnetic resonance angiography , renal artery obstruction , kidney , surgery , magnetic resonance imaging
Purpose To evaluate renal allograft vessels in the early period after kidney transplantation with three‐dimensional (3D) contrast‐enhanced MR angiography (3D CE MRA) using a parallel imaging technique. Materials and Methods Sixty‐three consecutive patients were examined with 3D CE MRA and integrated SENSE technique (Sensitivity Encoding) 2 to 21 days after renal transplantation. MR angiography studies were analyzed for the presence of arterial stenosis. The degree of renal transplant artery stenosis was graded qualitatively as <50% = mild, 50–70% = moderate, 70–99% = severe, and occlusion. Four patients (6.3%) with moderate (n = 1) or severe (n = 3) arterial stenoses on CE MRA underwent selective intra‐arterial digital subtraction angiography. In two patients, selective intravenous digital subtraction angiography (DSA) was performed. Results Twenty‐seven (42.9%) of the 63 patients had normal CE MR angiograms, 29 (46%) showed mild, 3 patients (4.8%) moderate, and 4 patients (6.3%) severe stenoses of the donor artery. In three patients, the severe stenosis of the graft artery was confirmed by surgery or intra‐arterial DSA. One patient with suspicion of severe arterial stenosis on MRA had moderate vessel narrowing on DSA. Twelve months after kidney transplantation, serum creatinine levels were not significantly different in patients with mild and moderate stenoses from those without ( P > 0.19) but significantly different from those with severe stenoses ( P < 0.05). Conclusion The incidence of mild and moderate vessel narrowing at the arterial anastomosis is unexpectedly high in the early period after kidney transplantation and is most likely due to surgery‐related tissue edema. J. Magn. Reson. Imaging 2009;29:909–916. © 2009 Wiley‐Liss, Inc.