| Diagnosis of renal artery stenosis: feasibility of combining MR angiography, MR renography, and gadopentetate-based measurements of glomerular filtration rate. | |
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MedLine Citation:
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PMID: 7484583 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Our aim was to evaluate the feasibility of combining in a single test (1) structural evaluation of renal arteries with MR angiography, (2) functional evaluation of global glomerular filtration rates calculated on the basis of plasma disappearance of gadopentetate dimeglumine, and (3) renographic analysis of individual kidneys based on the dynamic changes in signal intensity that occur after administration of gadopentetate dimeglumine. SUBJECTS AND METHODS: We used unenhanced MR angiography to measure patency of the renal arteries in 10 healthy volunteers and in 10 patients with renal artery stenosis. Calculations of global glomerular filtration rate were based on measurements of plasma disappearance of gadopentetate dimeglumine as shown by MR relaxometry. For renography with gadopentetate dimeglumine, we generated curves that showed changes in signal intensity in both kidneys over time; intrarenal kinetics were studied by measuring the time of arrival of gadopentetate dimeglumine in the cortex and outer medulla of the kidney. Conventional angiograms, measurements of global glomerular filtration rate based on plasma disappearance of 99mTc-DTPA, and 99mTc-DTPA renograms were used as reference standards. We compared the two different methods of determining global glomerular filtration rates by computing the correlation coefficient of the linear regression of rates derived from studies with gadopentetate dimeglumine versus rates derived from studies with 99mTc-DTPA. RESULTS: In all volunteers, renal arteries were well visualized, and global glomerular filtration rates based on plasma clearance of gadopentetate dimeglumine were normal. In nine of 10 patients, correlation was good between findings on MR angiograms and findings on conventional arteriograms. Finding were discordant in one patient because the patient moved during the MR angiography. For all six patients studied, correlation was good between measurements of global glomerular filtration rates based on plasma clearance of gadopentetate dimeglumine and those based on clearance of 99mTc-DTPA (r = 98%). CONCLUSION: Our results suggest the potential of magnetic resonance for a comprehensive approach for detection of renal artery stenosis. This novel approach provides structural evaluation of renal arteries with unenhanced MR angiography. MR renography is done and global glomerular filtration rates are determined by using MR relaxometry after injection of contrast material. Corticomedullary transit times can be determined on the basis of the dynamic changes in signal intensity that occur after administration of gadopentetate dimeglumine. |
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Authors:
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P R Ros; J Gauger; C Stoupis; S S Burton; J Mao; C Wilcox; E B Rosenberg; R W Briggs |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 165 ISSN: 0361-803X ISO Abbreviation: AJR Am J Roentgenol Publication Date: 1995 Dec |
Date Detail:
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Created Date: 1995-12-21 Completed Date: 1995-12-21 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1447-51 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology, University of Florida, College of Medicine, Gainesville 32610, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Contrast Media* Drug Combinations Gadolinium / diagnostic use* Gadolinium DTPA Glomerular Filtration Rate Humans Kidney / pathology*, physiopathology, radionuclide imaging Magnetic Resonance Angiography / instrumentation, methods* Magnetic Resonance Imaging / instrumentation, methods* Meglumine / diagnostic use* Middle Aged Organometallic Compounds / diagnostic use* Pentetic Acid / analogs & derivatives*, diagnostic use Reference Values Renal Artery Obstruction / diagnosis*, physiopathology Technetium Tc 99m Pentetate / diagnostic use |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Drug Combinations; 0/Organometallic Compounds; 6284-40-8/Meglumine; 65454-61-7/Technetium Tc 99m Pentetate; 67-43-6/Pentetic Acid; 7440-54-2/Gadolinium; 80529-93-7/Gadolinium DTPA |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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