Evaluation of the renal arteries in kidney donors: value of three-dimensional phase-contrast MR angiography with maximum-intensity-projection or surface rendering.

Meyers, S P; Talagala, S. Lalith; Tötterman, S.; Azodo, Michael V.U.; Kwok, Edmund; Shapiro, Leonid; Shapiro, Robert; Pabico, RC; Applegate, Gregory R.

doi:10.2214/ajr.164.1.7998523

Cited by 48 publications

(16 citation statements)

References 15 publications

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“…In comparison with CT, MRA uses no intravenously administered iodinated contrast material and no ionizing radiation, making it an attractive modality to use in the donor evaluation. Initial reports using nongadolinium-enhanced MRA suggested that accessory arteries are inadequately depicted with time-of-flight and phase-contrast techniques [13][14][15][16][17]. Studies comparing helical CT with noncontrast MRA concluded that CT was more accurate [17,18].…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance angiography for preoperative evaluation of potential kidney donors1

Rajab

Khabiri

Pelletier

et al. 2004

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 99%

Magnetic resonance angiography for preoperative evaluation of potential kidney donors1

Rajab

Khabiri

Pelletier

et al. 2004

Journal of Surgical Research

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“…With these technical improvements we expect increases in the detection rate of accessory vessels and peripheral arterial branches. We consider the clinical importance of detecting small accessory renal arteries higher in living kidney donors [33,34,35] than in patients after transplantation, because the knowledge about the arterial situation in kidney donors can help in deciding which kidney is suitable for transplantation. In addition, after transplantation the occlusion of small accessory vessels can be identified by perfusion defects, whereas existing accessory arteries are well known after transplantation from surgical history.…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced MR angiography in patients after kidney transplantation

Huber¹,

Heuck

Scheidler

et al. 2001

Eur Radiol

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The aim of this study was to investigate the value of a contrast-enhanced 3D MR angiography in detecting postoperative vascular complications after kidney transplantation in comparison with digital subtraction angiography (DSA). Forty-one patients who underwent a kidney transplantation were examined with MR angiography and DSA. Contrast-enhanced MR angiography was performed as a dynamic measurement with one precontrast and three postcontrast measurements. Maximum intensity projection reconstructions were performed for all postcontrast data sets after DSA. The results were evaluated by two independent observers who were unaware of the DSA results. Twenty-three hemodynamically significant arterial stenoses were identified with DSA in the iliac arteries ( n=7), the renal allograft arteries ( n=12), and in their first branches ( n=4). For a patient-based analysis the sensitivity and specificity, respectively, for observer 1 were 100 and 97%, and for observer 2, 100 and 93%. Respective data were 100 and 100% after a consensus evaluation by two observers. Complications involving the renal veins were detected in 2 cases and perfusion defects of the kidney parenchyma were detected in 4 cases. Contrast-enhanced MR angiography is a reliable method in identifying postoperative arterial stenoses after kidney transplantation. In addition, dynamic MR angiography can be helpful in detecting venous complications and perfusion defects in kidney allografts.

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“…Still, CTA requires x-ray exposure and IV contrast, so magnetic resonance imaging (MRI) was explored. Early accuracy was low, due to hardware or software limitations (14)(15)(16). Faster MRI scanners, which acquire high spatial resolution images during a single patient breath-hold, now achieve accuracy rates that rival CTA and conventional angiography (17,18).…”

Section: Introductionmentioning

confidence: 99%

Pre-donation Assessment of Kidneys by Magnetic Resonance Angiography and Venography: Accuracy and Impact on Outcomes

Ames

Krol²,

Nettar

et al. 2005

American Journal of Transplantation

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Reports on the accuracy of magnetic resonance angiography (MRA) and magnetic resonance venography (MRV) in evaluating living donor renovasculature employ few patients or omit the consequences of inaccurate scans. We retrospectively compared intraoperative findings to MRA/MRV scans in 146 donorrecipient pairs. For detecting accessory arteries and early branching, MRA sensitivity was 57.6%, specificity 96.5%, false positive rate 3.5%, false negative rate 42.4%, positive predictive value 82.6%, negative predictive value 88.6% and overall accuracy 87.7%. By excluding clinically inconsequential accessory arteries, MRA sensitivity rose to 73.1%, specificity to 96.7% and overall accuracy to 92.5%. For MRVs, sensitivity was 56.2%, specificity 99%, false positive rate 1%, false negative rate 43.8%, positive predictive value 90%, negative predictive value 94.8% and accuracy 94.5%. Inaccurate scans were associated with prolonged donor and recipient operations and more frequently reconstructed arteries, but did not affect clinical outcomes. Because most missed accessory arteries are inconsequential, MRA is a useful, less invasive method for defining donor renovascular anatomy.

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Evaluation of the renal arteries in kidney donors: value of three-dimensional phase-contrast MR angiography with maximum-intensity-projection or surface rendering.

Abstract: OBJECTIVE.Donors routinely undergo preoperative conventional arteriography to evaluate the renal arteries before nephrectomy.The purpose of this study was to assess the capability of three-dimensional

Cited by 48 publications

References 15 publications

Magnetic resonance angiography for preoperative evaluation of potential kidney donors1

Magnetic resonance angiography for preoperative evaluation of potential kidney donors1

Contrast-enhanced MR angiography in patients after kidney transplantation

Pre-donation Assessment of Kidneys by Magnetic Resonance Angiography and Venography: Accuracy and Impact on Outcomes

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