Accuracy of Normal-Dose Contrast-Enhanced MR Angiography in Assessing Renal Artery Stenosis and Accessory Renal Artery Stenosis and Accessory Renal Arteries
Michael B. J. M. Korst1,
Frank B. M. Joosten1,
Cornelis T. Postma2,
Gerrit J. Jager1,
Johan K. Krabbe1,3 and
Jelle O. Barentsz1
1
Department of Radiology, University Hospital Nijmegen, Geert Grooteplein 10,
P. O. Box 9101, 6500 HB Nijmegen, the Netherlands
2
Department of Internal Medicine, University Hospital Nijmegen, 6500 HB
Nijmegen, the Netherlands
3
Present address: Department of Radiology, Slingeland Ziekenhuis,
Kruisbergseweg 25, 7009 BL Doetinchem, the Netherlands
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Fig. 1. —Bar graph shows transit time of contrast material bolus in 38
patients; transit time is unknown in two patients (see text). Note that
transit time varied widely, implying that measurement of transit time is
essential for optimization of imaging sequence.
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Fig. 2. —75-year-old man with bilateral renal artery stenosis and accessory
renal artery. MR angiogram (maximum intensity projection) shows stenosis of
50-74% of right renal artery and stenosis of 75-99% of left renal artery.
Small accessory renal artery (arrow) supplies left lower pole of
kidney. Findings were confirmed on digital subtraction angiography.
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Fig. 3A. —47-year-old woman with hypertension and renal insufficiency. Digital
subtraction angiogram shows two accessory renal arteries (arrows,
A) on left. These accessory renal arteries were not detected on MR
angiography prospectively (false-negative findings). They are recognizable
(although difficult to see) on maximum intensity projection (arrows,
B). Quality of digital subtraction angiogram and MR angiogram was
prospectively classified as good.
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Fig. 3B. —47-year-old woman with hypertension and renal insufficiency. Digital
subtraction angiogram shows two accessory renal arteries (arrows,
A) on left. These accessory renal arteries were not detected on MR
angiography prospectively (false-negative findings). They are recognizable
(although difficult to see) on maximum intensity projection (arrows,
B). Quality of digital subtraction angiogram and MR angiogram was
prospectively classified as good.
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Fig. 4A. —67-year-old man with renal insufficiency. MR angiogram (A)
shows stenosis exceeding 50% in right renal artery (arrowhead) and
occlusion of main left renal artery (long arrow). Accessory renal
artery with stenosis of 75-99% was identified on left side (short
arrows). On digital subtraction angiogram (B) of moderate quality,
accessory renal artery was not recognized prospectively; after reevaluation,
MR findings were confirmed.
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Fig. 4B. —67-year-old man with renal insufficiency. MR angiogram (A)
shows stenosis exceeding 50% in right renal artery (arrowhead) and
occlusion of main left renal artery (long arrow). Accessory renal
artery with stenosis of 75-99% was identified on left side (short
arrows). On digital subtraction angiogram (B) of moderate quality,
accessory renal artery was not recognized prospectively; after reevaluation,
MR findings were confirmed.
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Fig. 5A. —60-year-old man with hypertension and mild renal insufficiency.
Maximum-intensity-projection MR image (A) and intraarterial digital
subtraction angiogram (B) show normal right renal artery and stenosis
of less than 50% (arrow) of left renal artery.
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Fig. 5B. —60-year-old man with hypertension and mild renal insufficiency.
Maximum-intensity-projection MR image (A) and intraarterial digital
subtraction angiogram (B) show normal right renal artery and stenosis
of less than 50% (arrow) of left renal artery.
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Fig. 6A. —37-year-old woman with hypertension. Intraarterial digital
subtraction angiogram (A) and MR angiogram (maximum intensity
projection) (B) show normal left renal artery. On digital subtraction
angiogram, stenosis of right renal artery (arrow) was classified as
50-74%; on MR angiogram stenosis was classified as 75-99%.
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Fig. 6B. —37-year-old woman with hypertension. Intraarterial digital
subtraction angiogram (A) and MR angiogram (maximum intensity
projection) (B) show normal left renal artery. On digital subtraction
angiogram, stenosis of right renal artery (arrow) was classified as
50-74%; on MR angiogram stenosis was classified as 75-99%.
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