Using gadolinium-enhanced three-dimensional MR angiography to assess arterial inflow stenosis after kidney transplantation.

Ferreirós, Joaquı́n; Méndez, Ramiro; Jorquera, Manuela; Gallego, J.; Lezana, A Hernández; Prats, D; Pedrosa, C. S.

doi:10.2214/ajr.172.3.10063875

Cited by 48 publications

(12 citation statements)

References 13 publications

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“…Alcuni autori [15][16][17] hanno valutato il ruolo dell'angiografia con risonanza magnetica (ARM) nella visualizzazione e caratterizzazione delle stenosi arteriose considerandola una metodica non invasiva per l'utilizzo intravenoso di gadolinio, l'assenza di raggi X e di accesso percutaneo; tutti hanno però utilizzato un tomografo RM a medio-alto campo magnetico 5 Tesla), senza menzionare le possibilità di utilizzo di un tomografo RM a basso campo (0,5 T). Per questo il nostro studio mira a valutare la variabilità tra gli esaminatori, la sensibilità, la specificità e l'accuratezza diagnostica della tomografia RM a basso campo con MdC, nella valutazione delle stenosi arteriose del rene trapiantato, con l'osservazione sia delle immagini originali, sia delle ricostruzioni digitali.…”

Section: Patientsunclassified

“…Some authors [15][16][17] have evaluated the role of magnetic resonance angiography (MRA) in the detection and characterisation of arterial stenosis, describing it as a noninvasive method that relies on intravenous injection of gadolinium and does not require ionising radiation or percutaneous access. However, all of these studies used medium-to-high magnetic field units (1-1.5 T) and contain no reference to the possible use of low-field MRI (0.5-T).…”

Section: Introductionmentioning

confidence: 99%

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Contrast-bolus MR angiography of the transplanted kidney with a low-field (0.5-T) scanner: diagnostic accuracy, sensitivity and specificity of images and reconstructions in the evaluation of vascular complications

et al. 2007

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Section: Patientsunclassified

Section: Introductionmentioning

confidence: 99%

Contrast-bolus MR angiography of the transplanted kidney with a low-field (0.5-T) scanner: diagnostic accuracy, sensitivity and specificity of images and reconstructions in the evaluation of vascular complications

et al. 2007

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“…Multiple investigators have documented a greater than 90% sensitivity and specificity of detecting a significant renal artery stenosis in transplant recipients with 3D Gd MRA. 42,43 Johnson and colleagues 44 have found that an imaging protocol combining 3D Gd MRA and 3D phase-contrast MRA appears to be the most sensitive and specific combination for detecting transplant renal artery stenosis with MRA.…”

Section: Vascular Complicationsmentioning

confidence: 99%

Interventional Radiological Management of the Complications of Renal Transplantation

Johnson¹,

Berry²

2001

Semin intervent Radiol

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“…[3] Second, the increasing use of Doppler ultrasound (DUS) and magnetic resonance angiography has led to an increased rate of detection of asymptomatic TRAS. [4]…”

Section: Introductionmentioning

confidence: 99%

Detection and treatment of transplant renal artery stenosis

et al. 2009

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Purpose:To assess the effects of transplant renal artery stenosis (TRAS) on blood pressure, renal function, and graft survival. To assess the usefulness of Doppler in predicting the clinical significance of TRAS and also to identify the predictive factors in Doppler that correlated with clinical features of TRAS.Materials and Methods:A prospective study was done on consecutive renal allograft recipients at Christian Medical College, over a period of 66 months from January 2002. All recipients underwent Doppler ultrasound (DUS) evaluation on the fifth post-operative day. Subsequent evaluation was done if the patients had any clinical or biochemical suspicion of TRAS. Angiogram was done in case of a high index of suspicion of significant stenosis or before angioplasty and stenting. The clinical and radiological outcomes of the patients with symptomatic or asymptomatic TRAS were analyzed.Results:Five hundred and forty three consecutive renal allograft recipients were analyzed, of whom, 43 were found to have TRAS. Nine recipients (21%) were detected to have TRAS on first evaluation. All had a high peak systolic velocities (PSV) recorded while 25 of them had other associated features. Patients with only high PSV required no further intervention and were followed up. They had a pretransplant mean arterial pressure (MAP) of 107.83 mmHg (SD = 13.32), ranging from 90 to 133 mm Hg and a posttransplant MAP of 106.56 mmHg (SD =16.51), ranging from 83 to 150 mm Hg. Their mean nadir serum creatinine was 1.16 mg% (SD = 0.24), at detection was 1.6 mg% (SD = 1.84) and at 6 months follow-up was 1.26 mg% (SD=0.52). Of the remaining 25 patients with other associated Doppler abnormalities, 11 required further intervention in the form of re-exploration in 2, angioplasty in 3 and stenting in 6 patients. One patient in the group of patients intervened, expired in the immediate post-operative period due to overwhelming urosepsis and consumption coagulopathy. The mean creatinine clearance (Cockroft-Gault method) in this group of remaining 10 patients, before and after intervention was 44.75 ml/min (SD=17.85) and 68.96 ml/min (SD = 10.56), respectively, with a mean increase by 24.21 ml/min (P=0.000). The mean arterial pressure before and after intervention in this group were 132.80 mm Hg (SD = 13.22) and 102 mm Hg (SD = 10.55), with a decline in the MAP by 30.80 mmHg (P=0.017). The haemoglobin levels also increased from 11.72 (SD=2.13) to 12.48 gm% (SD = 1.75), with a mean increase by 0.76 gm% (P=0.05).Conclusions:Patients with isolated high PSV do not have a significant alteration of blood pressure or allograft function and required no intervention. Although high PSV with associated Doppler anomalies are more suggestive of significant TRAS, the decision regarding surgical intervention is largely based on clinical assessment.

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Using gadolinium-enhanced three-dimensional MR angiography to assess arterial inflow stenosis after kidney transplantation.

Cited by 48 publications

References 13 publications

Contrast-bolus MR angiography of the transplanted kidney with a low-field (0.5-T) scanner: diagnostic accuracy, sensitivity and specificity of images and reconstructions in the evaluation of vascular complications

Contrast-bolus MR angiography of the transplanted kidney with a low-field (0.5-T) scanner: diagnostic accuracy, sensitivity and specificity of images and reconstructions in the evaluation of vascular complications

Interventional Radiological Management of the Complications of Renal Transplantation

Detection and treatment of transplant renal artery stenosis

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