Abstract-Noninvasive testing for renovascular disease is required to identify patients who may benefit from revascularization procedures without exposing an unnecessary amount of patients to the risks of catheter angiography. All available methods of diagnosing renal artery stenosis have significant limitations. We compared a new technique, contrast-enhanced magnetic resonance angiography, with an established technique, duplex ultrasonography, for the detection of renal artery stenosis using catheter angiography as the standard of reference. Eighty-nine patients with clinically suspected renovascular disease underwent duplex renal scanning and contrast-enhanced magnetic resonance angiography. Sixty of these also underwent catheter angiography. All studies were interpreted for the presence of renal artery stenosis blinded to the results of the other imaging modalities. For detection of hemodynamically significant (Ն60% diameter reduction) main renal artery stenosis, sensitivity and specificity were 90% and 86%, respectively, for magnetic resonance angiography and 81% and 87% for duplex sonography. Most false readings involved differential grading of stenoses detected with all 3 techniques. When patients with fibromuscular dysplasia were excluded from the analysis, the sensitivity of magnetic resonance angiography increased to 97%, with a negative predictive value of 98%. Magnetic resonance angiography detected 96% and duplex 5% of accessory renal arteries seen at catheter angiography. Contrast-enhanced magnetic resonance angiography is a useful technique for diagnosing atherosclerotic renovascular disease. It overcomes the major limitations of duplex renal scanning. However, duplex has the advantage of providing hemodynamic information and appears better suited for the assessment of patients with suspected fibromuscular dysplasia. (Hypertension. 1999;33:726-731.)

Compared with other coil designs that have been investigated for intravascular use, the single‐loop coil can be designed with a very small diameter for insertion into small vessels and with a longitudinal extent over several centimeters for multislice imaging. If it designed to be expandable inside the target vessel, then it combines these features with increased signal‐to‐noise ratio (SNR) and penetration depth. Expandable single‐loop coils that are capable of meeting these requirements were developed and integrated into two different commercial catheter‐based delivery systems: a self‐expandable, single‐loop made from NiTinol and a single‐loop coil mounted on an inflatable balloon. The influence of a small‐diameter coaxial cable for remote tuning and matching on the coil performance was investigated. Calculations showed the dependence of the signal on the separation between the conductors. The comparison of both catheter approaches in in vitro flow experiments and in an in vivo pig experiment revealed the influence of pulsatile flow on image quality during intravascular imaging with these designs. Magn Reson Med 41:751–758, 1999. © 1999 Wiley‐Liss, Inc.

Compared with other coil designs that have been investigated for intravascular use, the single-loop coil can be designed with a very small diameter for insertion into small vessels and with a longitudinal extent over several centimeters for multislice imaging. If it designed to be expandable inside the target vessel, then it combines these features with increased signal-to-noise ratio (SNR) and penetration depth.

No abstract

Our purpose in this study was to evaluate the steerability of a combined catheter guidewire system with MR tracking in an open-configuration .5T MR system and compare it with fluoroscopic guidance. Experiments were performed with an aorta-shaped glass phantom with different-size branches connected to a roller flow pump to simulate pulsatile flow. A .035" guidewire was used in conjunction with a 5F Cobra 2-shaped catheter. For active MR guidance, a small RF coil was incorporated into the tips of all devices. In addition to fluoroscopic guidance, we used MR tracking devices to selectively catheterize all branches in the .5T open magnet (Signa SP, GEMS). Time requirements for the latter were compared with those needed under conventional angiographic conditions using standard catheters and guidewires. Active MR tracking permitted the simultaneous real time (4 updates/sec) guidance of both guidewire and catheter. Under MR guidance, all branch vessels were successfully catheterized. We found no significant differences in time requirements between guidance with the MR tracking device and fluoroscopic guidance. However, cannulation under fluoroscopic guidance with standard angiography devices required significantly less time (P < .05). Selective catheterization of small branch vessels is possible with active MR tracking of a combined catheter/guidewire system. Limitations of MR tracking device material and design result in a considerable lengthening of the cannulation procedures.