Open AccessPreoperative evaluation of renal artery in patients with renal tumor
Author(s) -
Liangsong Zhu,
Guangyu Wu,
Jianfeng Wang,
Jiwei Huang,
Wen Kong,
Yonghui Chen,
Wei Xue,
Yiran Huang,
Zhendong Jin
Publication year - 2016
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000005025
Subject(s) - medicine , nephrectomy , renal artery , magnetic resonance angiography , magnetic resonance imaging , kidney , computed tomographic angiography , radiology , angiography , artery , renal tumor , retrospective cohort study , nuclear medicine , surgery
To investigate the feasibility of the noncontrast-enhanced magnetic resonance angiography (NCE-MRA) to evaluate renal arteries before partial nephrectomy (PN). Retrospective analyzed 479 patients who underwent renal surgery between January 2013 and December 2015 with NCE-MRA or computed tomographic angiography (CTA) renal artery image reconstruction preoperative in our department. The renal artery reconstruction score (RARS) was based on the level of artery visualization in a 4-class criterion, and the R.E.N.A.L nephrometry score (R.E.N.A.L), arterial based complexity (ABC) were also analyzed. Of the 479 patients, the overall-lever RARS was 3.62, and the average in 2 groups was no significant difference (NCE-MRA vs CTA, P = 0.072). The performance of NCE-MRA in PN group was similar with CTA. Further comparison demonstrated that the efficiency of NCE-MRA in moderate- or low-degree tumor according to the R.E.N.A.L and ABC complexity less than 3S was equal to CTA. However, high degree ( P < 0.001), 3S ( P = 0.027), or 3H ( P < 0.001) would affect the imaging of renal artery. Intragroup analysis showed that tumor complexity such as max tumor size ( r = −o.351, P < 0.001), R.E.N.A.L ( r = −0.439, P < 0.001), and ABC ( r = −0.619, P < 0.001) were closely correlated with the NCE-MRA performance. The images of 2 sides of the kidney were compared in single person as well, which was meaningful for NCE-MRA patients only (NCE-MRA, P < 0.001; CTA, P = 0.182). The renal artery reconstruction performed by NCE-MRA is feasible and has a similar achievement in the PN potential recipients, with a lower side effect, and meets the requirements for making surgical decision. It has a broad application prospect in clinical practice; however, it still needs to further improve the ability in more complex tumors.