Renal Transplant: Nonenhanced Renal MR Angiography with Magnetization-prepared Steady-State Free Precession

Liu, Xin; Berg, Natasha; Sheehan, John J.; Bi, Xiaoming; Weale, Peter; Jerec̆ić, Renate; Carr, James C.

doi:10.1148/radiol.2512081094

Cited by 54 publications

(44 citation statements)

References 26 publications

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“…The incidence of vascular complications in our study group was comparable to those reported by Liu X et al (8); graft artery thrombosis (1%), graft artery stenosis (1.5% -10%) and graft artery pseudo-aneurysm (1%).…”

Section: Discussionsupporting

confidence: 90%

“…Our results, concerning the distribution of posttransplantation fluid collections, are comparable to Fang et al (8) in that the patients with peri-graft hematomas and urinomas were detected within the 1 st postoperative two weeks while those with lymphoceles and abscesses formation were detected at variable post-operative periods.…”

Section: Discussionsupporting

confidence: 90%

“…The sensitivity, specificity, overall accuracy and positive predictive values for 3D-Gd enhanced FSPGR MRA and 3D-PC MRA, performed for 30 patients, for the detection of graft arteries stenosis were: These data are comparable to those reported by Liu X et al (8) concerning the sensitivity and specificity for 3D-TOF and 3D-PC MRA in evaluation of post renal transplant artery stenosis which were: However our data are incomparable to those reported by Huber et al (10) which were: The sensitivity, specificity an overall accuracy of MIP and MPR images were 66.6%, 100%, 98.6% and 100% for detection of graft arteries thrombosis while they were 100%, 96.8%, 97.2%, 100%, 98.4% and 98.6% for detection of graft arteries stenosis.…”

Section: Discussionsupporting

confidence: 84%

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Post Renal Transplant Surgical Complications; MRI Standard Applications and Diagnostic Outcomes

Ella¹

2017

IJMI

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Abstract:Objective: Fast MR imaging sequences together with paramagnetic contrast agents, offer multiple advantages in the assessment of renal function. It provides cross sectional and vascular information without the risk of ionizing radiation, iodinated contrast or arterial catheterization. Post transplantation complications can be grouped as surgical or medical. Immediate surgical complications include renal artery thrombosis or stenosis, urinary leak or lymphocele. Renal allograft frequently require repeated imaging studies during the immediate post-operative period and various times thereafter, when renal function is compromised. Background: End stage renal disease is common and can result from a variety of diseases. Kidney transplantation from living-related donors offered the best prognosis. Imaging modalities that are currently used to evaluate transplanted kidneys are ultrasound (US), computed tomography (CT), scintigraphy, intravenous urography (IVU), contrast angiography, and magnetic resonance imaging (MRI). Methods: This study was conducted on 181 renal transplant recipients. Recipients were 139 males and 42 females. Their age ranged from 20 to 58 years (mean age 39 years). The patients underwent clinical assessment, Laboratory investigations, and different Radiological imaging procedures as: I-Gray scale and color Doppler ultrasonography. II-Magnetic Resonance Imaging. 3D Gd-enhanced MRA. MR Urography. Selective IA-DSA of the graft artery. III-Percutaneous catheter nephrostomy (PCN) and antegrade pyelography. IV-Radio-isotope diuretic renogram using 99m Tc-MAG3. Results: 30 renal transplants were examined by MRI in the 1st 2 weeks after renal transplantation. At the end of 1st 2 weeks, MR examinations were carried out, as basal studies (including MRI, MRA and MRU) for 98 transplants. From this group, 64 transplants were subjected to other MR examinations. After the 1st 2 weeks, 53 transplants were subjected to MR examinations for the 1st time at variable post-transplant duration. Among the studied 181 renal transplants, MR examinations detected 3 cases with graft arteries thrombosis (1.6%), 10 with graft arteries stenosis (5.5%), 6 with segmental infarctions (3.3%), 3 cases with graft intrarenal arteries pseudo-aneurysms (1.6%) and 2 cases with arterio-venous fistulae (1.1%) after graft biopsies. Conclusion: MRI is highly recommended to evaluate intra-/extra-renal graft vascular lesions, urinary obstructive syndrome, compressive collections (urinoma, lymphocele), inflammatory and tumoral lesions of the renal graft.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 84%

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Post Renal Transplant Surgical Complications; MRI Standard Applications and Diagnostic Outcomes

Ella¹

2017

IJMI

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“…Magnetic reso nance angiography is increasingly used to screen for vascular abnormalities in renal allografts ( Figure 5). 41,51,53 Due to fear of nephrogenic systemic fibrosis after gadolinium-based contrast agents in patients with decreased glomerular filtration rate, imaging modalities have been developed to view the vessels without intravenous contrast. 41,44 Limitations of magnetic resonance imaging include the inability to image patients with pace makers, greater cost, lack of portability, and prolonged examination time, which is not suited to these critically ill patients.…”

Section: Clinical Manifestations Of Transplant Renal Vein Thrombosismentioning

confidence: 99%

Untitled

Zorkany

Bridson²,

Sharma³

et al. 2017

Exp Clin Transplant

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Transplant renal vein thrombosis usually occurs early after surgery with a reported prevalence of 0.1% to 4.2%. It is a devastating event that ultimately leads to graft loss in almost all cases. There are many predisposing factors related to donor, recipient, surgery, and immunosuppression, with mechanical factors being considered the most common causes of transplant renal vein thrombosis. The clinical manifestations of acute renal vein thrombosis are nonspecific and are not dissimilar to the features of urine leak, urinary obstruction, or severe acute rejection. The diagnosis of transplant renal vein thrombosis depends on a high index of clinical suspicion and duplex ultrasonographic scans. Although venography remains the criterion standard, this procedure is invasive and nephrotoxic, due to use of ionizing contrast agents and also due to exposure to ionizing radiation. There are 2 therapies that have been described in the literature for salvaging a renal allograft with transplant renal vein thrombosis: thrombolytic therapy and surgical thrombectomy. The usual end result is renal allograft nephrectomy because the diagnosis is almost always too late.

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“…A 3D gradient-echo sequence could then be initiated for angiography if contrast is used [1,29] . Table 1 displays the main findings of the studies investigating the use of MRA for the assessment of transplanted kidneys [1,[28][29][30][31][32][33][34] . The primary strength of MRA is evaluating the stenosis of relevant arteries, and the results of these studies have shown a generally good correlation of MRA with digital subtraction angiography (DSA), which is the golden standard for vascular abnormalities.…”

Section: Mr Nephro-urography/renographymentioning

confidence: 99%

Functional assessment of transplanted kidneys with magnetic resonance imaging

Wang

Yin

et al. 2015

WJR

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Kidney transplantation has emerged as the treatment of choice for many patients with end-stage renal disease, which is a significant cause of morbidity and mortality. Given the shortage of clinically available donor kidneys and the significant incidence of allograft dysfunction, a noninvasive and accurate assessment of the allograft renal function is critical for postoperative management. Prompt diagnosis of graft dysfunction facilitates clinical intervention of kidneys with salvageable function. New advances in magnetic resonance imaging (MRI) technology have enabled the calculation of various renal parameters that were previously not feasible to measure noninvasively. Diffusion-weighted imaging provides information on renal diffusion and perfusion simultaneously, with quantification by the apparent diffusion coefficient, the decrease of which reflects renal function impairment. Diffusion-tensor imaging accounts for the directionality of molecular motion and measures fractional anisotropy of the kidneys. Blood oxygen level-dependent MR evaluates intrarenal oxygen bioavailability, generating the parameter of R2* (reflecting the concentration of deoxyhemoglobin). A decrease in R2* could happen during acute rejection. MR nephro-urography/renography demonstrates structural data depicting urinary tract obstructions and functional data regarding the glomerular filtration and blood flow. MR angiography details the transplant vasculature and is particularly suitable for detecting vascular complications, with good correlation with digital subtraction angiography. Other functional MRI technologies, such as arterial spin labeling and MR spectroscopy, are showing additional promise. This review highlights MRI as a comprehensive modality to diagnose a variety of etiologies of graft dysfunction, including prerenal (e.g. , renal vasculature), renal (intrinsic causes) and postrenal (e.g. , obstruction of the collecting system) etiologies.

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Renal Transplant: Nonenhanced Renal MR Angiography with Magnetization-prepared Steady-State Free Precession

Cited by 54 publications

References 26 publications

Post Renal Transplant Surgical Complications; MRI Standard Applications and Diagnostic Outcomes

Post Renal Transplant Surgical Complications; MRI Standard Applications and Diagnostic Outcomes

Untitled

Functional assessment of transplanted kidneys with magnetic resonance imaging

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