Comparison of non-breath-hold high resolution gadolinium-enhanced MRA with digital subtraction angiography in the evaluation on allograft renal artery stenosis

AIM: The study objective was to compare the diagnostic accuracy of non-breath-hold high resolution gadolinium-enhanced magnetic resonance angiography (Gd-MRA) with intra-arterial digital subtraction angiography (DSA) in the evaluation of allograft renal artery stenosis (ARAS), MATERIALS AND METHODS: We studied 17 renal transplant recipients (six men, 11 women, age 34-64 years) with a systolic bruit in the transplant region beyond the early post-operative period, Gadolinium-enhanced magnetic resonance angiography was performed by non-breath-hold high resolution 3D acquisition in the oblique coronal plane using a 256 x 512 matrix, Digital subtraction angiography was performed with AP and oblique views and ARAS was graded as less than or equal to 50% or >50% diameter stenosis on the view that displayed the maximal narrowing, RESULTS: Digital subtraction angiography showed >50% stenosis in seven patients, all of whom were diagnosed correctly on Gd-MRA, Gadolinium-enhanced magnetic resonance angiography diagnosed two patients with >50% stenosis which were not confirmed on DSA, Eight patients had no or >50% stenosis on both Gd-MRA and DSA. The sensitivity and specificity of Gd-MRA in revealing >50% stenosis were 100% and 75%, respectively, using DSA as the gold standard. CONCLUSION: High resolution Gd-MRA employing a non-breath-hold technique is highly sensitive in the diagnosis of ARAS greater than 50%, It is preferred as a non-invasive screening technique to DSA in suspected ARAS. Chan, Y. L. et al. (2001). Clinical Radiology 56, 127-132. (C) 2001 The Royal College of Radiologists.