Document Detail


Steady-state free precession MRA of the renal arteries: breath-hold and navigator-gated techniques vs. CE-MRA.
MedLine Citation:
PMID:  17896351     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To explore the use of breath-hold and navigator-gated noncontrast Steady State Free Precession (SSFP) MR angiography (MRA) protocols for the evaluation of renal artery stenosis (RAS). MATERIALS AND METHODS: Twenty patients referred to rule out RAS were imaged using two breath-hold and one navigator-gated SSFP MRA sequences. All patients underwent contrast-enhanced MRA (CE-MRA). Two radiologists evaluated all sequences both qualitatively (blur, artifacts, reader confidence) and quantitatively (maximum stenosis). Using CE-MRA as truth, a receiver operating characteristics (ROC) curve was generated and a statistical analysis of navigator-gated SSFP (Nav SSFP) was performed. RESULTS: Seven patients had >50% renal artery stenosis by CE-MRA. Nav SSFP performed significantly better than either breath-hold SSFP technique in terms of blur, artifacts, and reader confidence. Using a 50% threshold for stenosis, sensitivity for detecting RAS was 100%, with a specificity of 85% and a negative predictive value of 100%. The average mean stenosis difference between Nav SSFP and CE-MRA was 9 +/- 9%. CONCLUSION: Nav SSFP outperformed breath-hold SSFP in measures of image quality and reader confidence. Sensitivity and negative predictive value for detecting RAS with Nav SSFP was perfect, with an acceptable specificity of 85%. This suggests further study is warranted to evaluate Nav SSFP as a noncontrast screening technique for renal artery stenosis.
Authors:
Jeffrey H Maki; Gregory J Wilson; William B Eubank; David J Glickerman; Sudhakar Pipavath; Romhild M Hoogeveen
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of magnetic resonance imaging : JMRI     Volume:  26     ISSN:  1053-1807     ISO Abbreviation:  J Magn Reson Imaging     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-01     Completed Date:  2008-01-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9105850     Medline TA:  J Magn Reson Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  966-73     Citation Subset:  IM    
Copyright Information:
(c) 2007 Wiley-Liss, Inc.
Affiliation:
Puget Sound VA Health Care System, Department of Radiology, Seattle, Washington, USA. jmaki@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Contrast Media / pharmacology
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Predictive Value of Tests
ROC Curve
Radiology / methods*
Renal Artery / pathology
Renal Artery Obstruction / diagnosis*,  pathology*
Reproducibility of Results
Respiration
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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