Accuracy of Computed Tomographic Angiography and Magnetic Resonance Angiography for Diagnosing Renal Artery Stenosis

Vasbinder, G. Boudewijn C.; Nelemans, Patricia J.; Kessels, Alfons G.H.; Kroon, Abraham A.; Maki, Jeffrey H.; Leiner, Tim; Beek, F. J. A.; Korst, Michael B. J. M.; Flobbe, Karin; Haan, Michiel W. de; Zwam, Willem H. van; Postma, Cornelis T.; Hunink, M. G. Myriam; Leeuw, Peter W. de; Engelshoven, Jos M. A. van

doi:10.7326/0003-4819-141-9-200411020-00007

Cited by 326 publications

(122 citation statements)

References 32 publications

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“…We performed systematic RA in consecutive AMI patients, regardless of other risk factors suggesting RAS (severe hypertension, PAD, or abdominal bruits). Data showed concordant values of RAS prevalence in AMI (16.6%) to those reported in well‐recognized risk groups (suspected renovascular hypertension5, 30—14.1%, hypertension and diabetes mellitus31—17.1%, chronic CAD5, 32, 33—9.1% to 10.8%) but lower values than in patients with chronic heart failure34—54.1%, aortic abdominal aneurysm35—38%, end‐stage renal disease36—40.8%. Differences between reports are driven by inclusion of patients with different stages of atheromatous disease and inflammation.…”

Section: Discussionsupporting

confidence: 65%

Atherosclerotic Renal Artery Stenosis Prevalence and Correlations in Acute Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Interventions: Data From Nonrandomized Single‐Center Study (REN‐ACS)—A Single Center, Prospective, Observational Study

Burlacu¹,

Siriopol

Voroneanu

et al. 2015

JAHA

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BackgroundWe are the first to evaluate the prevalence of renal artery stenosis (RAS) in consecutive patients with acute myocardial infarction (AMI) referred for primary percutaneous coronary intervention from a single tertiary center. As a novelty, we assessed hydration and metabolic status and measured arterial stiffness. We elaborated a predicting model for RAS in AMI.Methods and ResultsOne hundred and eighty‐one patients with AMI underwent concomitantly primary percutaneous coronary intervention and renal angiography. We obtained data on demographics, medical history, cardiovascular risk factors, echocardiography, Killip class, and blood tests. In the first 24 hours post–primary percutaneous coronary intervention, we assessed bioimpedance through Body Composition Monitoring® and arterial stiffness through pulsed‐wave velocity, SphygmoCor®. Significant RAS (>50% lumen narrowing, RAS+) was present in 16.6% patients. In the RAS+ group we recorded significantly higher stiffness, CRUSADE score and dehydration, and more women with higher prevalence of multivascular coronary artery disease and heart failure. In our multivariate models, variables independently associated with RAS+ were previous percutaneous coronary intervention, low estimated glomerular filtration rate, multivascular coronary artery disease, and total/extracellular body water. These models had good specificity and low sensitivity.ConclusionsWe observed that RAS+ AMI patients have a particular hydration, metabolic, and endothelial profile that could generate more future major adverse cardiac events. Hence, renal angiography in AMI should be considered in specific subsets of patients.Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02388139.

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Section: Discussionsupporting

confidence: 65%

Atherosclerotic Renal Artery Stenosis Prevalence and Correlations in Acute Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Interventions: Data From Nonrandomized Single‐Center Study (REN‐ACS)—A Single Center, Prospective, Observational Study

Burlacu¹,

Siriopol

Voroneanu

et al. 2015

JAHA

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“…Later work using CE-MRA, such as the RADISH and DRAS-TIC trials (4,5) predominantly focused on investigating hypertensive patients with a lower disease prevalence, and yielded lower specificities and particularly lower sensitivities. This can at least in part be ascribed to a lack of spatial resolution in the CE-MRA techniques used at the time of those trials, which was only adequate to characterize ostial main renal artery disease.…”

Section: Atheroscelroticmentioning

confidence: 99%

Renovascular imaging in the NSF Era

Roditi

Maki

Oliveira

et al. 2009

Magnetic Resonance Imaging

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The detection of the association between nephrogenic systemic fibrosis (NSF), a rare but potentially life‐threatening disease only encountered in patients with severely impaired renal function, and the previous administration of some Gd‐chelates has cast a shadow on the administration of Gd‐chelates in patients with chronic renal failure. So far, contrast‐enhanced MR‐angiography (MRA) was considered the best diagnostic modality in patients with suspected renal disease. This review explores the most appropriate use of renal MRA with a focus on newly developed nonenhanced MRA techniques. Nonenhanced MRA techniques mainly based on SSFP with ECG‐gating allow for acceptable spatial resolution to visualize at least the proximal parts of the renal arteries. In addition functional renal imaging techniques and their current clinical role are critically appreciated. J. Magn. Reson. Imaging 2009;30:1323–1334. © 2009 Wiley‐Liss, Inc.

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“…While it provides a more accurate diagnosis than ultrasound, CE-MRA carries significantly less risk than the "gold standard" conventional angiography (CA) (6 -11). However, a recent study based on the routine use of CE-MRA showed that it was relatively less effective for grading RAS and insensitive for detecting distal RA disease, such as fibromuscular dysplasia (12). While there is clearly a role for renal CE-MRA as a noninvasive tool in diagnosing RA disease, there is a need for improvement in its ability to precisely depict RAs.…”

Section: Contrast-enhanced Mr Angiography (Ce-mra)mentioning

confidence: 99%

Utilizing SENSE to reduce scan duration in high‐resolution contrast‐enhanced renal MR angiography

Wilson

Eubank

Vasbinder

et al. 2006

Magnetic Resonance Imaging

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Purpose:To evaluate the use of sensitivity encoding (SENSE) to reduce scan time and decrease detrimental artifacts arising from motion and bolus profile effects during contrast-enhanced MR angiography (CE-MRA) of the renal arteries (RAs). Materials and Methods:A direct comparison of conventional and SENSE (acceleration factor 2) CE-MRA protocols was performed on 20 patients. Each patient underwent both scans. Both protocols achieved the same resolution, but the SENSE protocol was 50% faster and utilized a faster injection than the conventional scan. Three radiologists graded the images for image quality, artifact levels, and reader confidence.Results: While the signal-to-noise ratio (SNR) decreased (26 Ϯ 5 vs. 30 Ϯ 10; P ϭ 0.04) with the SENSE protocol, the image-quality scores for four identified segments of the RAs increased or were unchanged. The largest improvements in image quality occurred in the more distal segments of the RAs. Parenchymal ringing (P ϭ 0.005) and RA blurring (P ϭ 0.006) were significantly reduced, and there was a trend toward improvement of RA ringing despite the increased injection rate. Conclusion:The faster SENSE scan maintained nearly the same SNR (due to faster injection of Gd-chelate), reduced artifact levels, and improved image quality ratings for the distal renal vessels.

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Accuracy of Computed Tomographic Angiography and Magnetic Resonance Angiography for Diagnosing Renal Artery Stenosis

Cited by 326 publications

References 32 publications

Atherosclerotic Renal Artery Stenosis Prevalence and Correlations in Acute Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Interventions: Data From Nonrandomized Single‐Center Study (REN‐ACS)—A Single Center, Prospective, Observational Study

Atherosclerotic Renal Artery Stenosis Prevalence and Correlations in Acute Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Interventions: Data From Nonrandomized Single‐Center Study (REN‐ACS)—A Single Center, Prospective, Observational Study

Renovascular imaging in the NSF Era

Utilizing SENSE to reduce scan duration in high‐resolution contrast‐enhanced renal MR angiography

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