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首页> 外文期刊>European radiology >Renal artery stenosis: comparative assessment by unenhanced renal artery mra versus contrast-enhanced MRA.
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Renal artery stenosis: comparative assessment by unenhanced renal artery mra versus contrast-enhanced MRA.

机译：肾动脉狭窄：通过未增强的肾动脉mra与对比增强的MRA进行比较评估。

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OBJECTIVES: To evaluate steady-state free precession (SSFP) non-contrast-enhanced MR angiography (Unenhanced-MRA) versus conventional contrast-enhanced MR angiography (CE-MRA) in the detection of renal artery stenosis (RAS). METHODS: Retrospective analysis of 70 consecutive patients referred for suspected RAS, examined by SSFP Unenhanced-MRA and CE-MRA. Image quality, quality of visible renal arterial segments, presence and grade of RAS were evaluated. The Unenhanced-MRA were compared against reference standard CE-MRA results. RESULTS: 149 renal arteries were assessed with 21 haemodynamically significant stenoses (>/= 50% stenosis) demonstrated by CE-MRA. Combined sensitivity and specificity for RAS detection by Unenhanced-MRA was 72.8% and 97.8% respectively. There is substantial correlation for RAS detection between Unenhanced-MRA and CE-MRA with kappa values of between 0.64 and 0.74. There was excellent inter-observer correlation for RAS on Unenhanced-MRA (kappa values 0.82-1.0). CONCLUSIONS: Our study has shown Unenhanced-MRA to be a viable alternative to CE-MRA, yielding images equal in quality without the requirement for gadolinium contrast agents. The sensitivity and specificity for the detection of haemodynamically significant stenoses are comparable to CE-MRA. Potentially, Unenhanced-MRA could be used as an initial investigation to avoid performing CE-MRA in patients with normal renal arteries, however we suggest that its real value will lie in being complementary to CE-MRA.
机译：目的：评估稳态自由进动（SSFP）非对比增强MR血管造影（Unenhanced-MRA）与常规对比增强MR血管造影（CE-MRA）在检测肾动脉狭窄（RAS）中的作用。方法：回顾性分析70例连续疑似RAS的患者，通过SSFP Unenhanced-MRA和CE-MRA检查。评估图像质量，可见肾动脉节段质量，RAS的存在和等级。将未增强的MRA与参考标准CE-MRA结果进行了比较。结果：CE-MRA评估了149个肾动脉，其中有21个血液动力学显着的狭窄（> / = 50％狭窄）。 Unenhanced-MRA对RAS检测的综合敏感性和特异性分别为72.8％和97.8％。未增强的MRA和CE-MRA之间的RAS检测具有很大的相关性，κ值在0.64到0.74之间。在未增强的MRA上，RAS的观察者间相关性极好（kappa值为0.82-1.0）。结论：我们的研究表明Unenhanced-MRA是CE-MRA的可行替代方案，可产生质量相等的图像，而无需使用contrast造影剂。检测血流动力学显着狭窄的敏感性和特异性与CE-MRA相当。潜在地，未增强的MRA可以用作避免在肾动脉正常的患者中进行CE-MRA的初步研究，但是我们建议其真正价值在于与CE-MRA互补。

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