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Non-contrast-enhanced magnetic resonance angiography: a reliable clinical tool for evaluating transplant renal artery stenosis

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Abstract

Purpose

To evaluate image quality of non-contrast-enhanced magnetic resonance angiography (MRA) and compare transplant renal artery stenosis (TRAS) seen by non-contrast-enhanced MRA with digital subtraction angiography (DSA) as the gold standard.

Materials and methods

330 patients receiving 369 non-contrast-enhanced MRA examinations from July 2014 to June 2017 were included. Thirty patients received at least two MRA examinations. Image quality was independently assessed by two radiologists. Inter-observer agreement was analyzed. Transplant renal artery anatomy and complications were evaluated and compared with DSA. If possible, accuracy was calculated on a per-artery basis.

Results

Good or excellent image quality was found in 95.4 % (352/369) of examinations with good inter-observer agreement (K=0.760). Twenty-two patients with DSA had 28 non-contrast-enhanced MRA examinations within a 2-month period. Of these, 19 patients had TRAS, two patients had pseudoaneurysms, and one patient had a normal transplant renal artery but an occluded external iliac artery. Non-contrast-enhanced MRA correctly detected 19 TRAS and nine normal arteries, giving 96.6 % accuracy on a per-artery basis.

Conclusions

Non-contrast-enhanced MRA demonstrates a good depiction of the transplanted renal artery and shows good correlation with DSA in cases where there was TRAS.

Key Points

• Good or excellent image quality was found in 95.4 % of examinations.

• Non-contrast-enhanced MRA can clearly map transplant renal artery anatomy.

• Non-contrast-enhanced MRA is a reliable tool to detect TRAS.

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Abbreviations

CKD:

Chronic kidney disease

CTA:

CT angiography

DSA:

Digital subtraction angiography

IFIR:

Inflow inversion recovery

MRA:

Magnetic resonance angiography

SSFP:

Steady-state free precession

TRAS:

Transplant renal artery stenosis

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Funding

The authors state that this work has not received any funding.

Author information

Author notes

  1. Long Jiang Zhang and Jin Peng contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China

    Long Jiang Zhang, U. Joseph Schoepf, Yuan Meng Yu, Shu Min Tao, Yan Jun Li, Jian Xu, Dong Hong Shi & Guang Ming Lu

  2. Department of Medical Imaging, Jinling Hospital, Nanjing Clinical School, Southern Medical University, Nanjing, Jiangsu Province, 210002, China

    Jin Peng, Xue Feng Ni & Guang Ming Lu

  3. National Clinical Research Center of Kidney Disease, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China

    Jiqiu Wen

  4. Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA

    U. Joseph Schoepf, Akos Varga-Szemes & L. Parkwood Griffith

Authors
  1. Long Jiang Zhang
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  2. Jin Peng
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Corresponding authors

Correspondence to Long Jiang Zhang or Jiqiu Wen.

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Guarantor

The scientific guarantor of this publication is Long Jiang Zhang.

Conflict of interest

UJS is a consultant for and/or receives research support from Astellas, Bayer, General Electric, Guerbet and Siemens Healthineers. AVS received research support from Siemens Healthineers. All other authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Cite this article

Zhang, L.J., Peng, J., Wen, J. et al. Non-contrast-enhanced magnetic resonance angiography: a reliable clinical tool for evaluating transplant renal artery stenosis. Eur Radiol 28, 4195–4204 (2018). https://doi.org/10.1007/s00330-018-5413-3

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  • DOI: https://doi.org/10.1007/s00330-018-5413-3

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