Non-invasive assessment of renal artery stenosis: current concepts and future directions in magnetic resonance angiography

J Comput Assist Tomogr. 1999 Nov:23 Suppl 1:S111-7. doi: 10.1097/00004728-199911001-00015.

Abstract

Magnetic resonance angiography is undergoing rapid development as a non-invasive technique to reliably assess renal artery stenosis. Invasive X-ray angiography is currently the gold standard imaging technique and gives excellent spatial resolution. However, its disadvantages include a necessary exposure to radiation and the need for iodinated contrast media. While magnetic resonance angiography does not have these disadvantages, its spatial resolution is inherently lower. On the other hand, magnetic resonance angiography enables true three-dimensional imaging. The use of rapid imaging techniques allows multiple image acquisition within one breath-hold thereby permitting the visualization of distinct vascular phases. The limitation in spatial resolution can be overcome readily by combining morphologic imaging with functional information on the hemodynamic relevance. This can be achieved by means of magnetic resonance phase contrast flow measurements. The use of such a combined approach enables the grading of vascular stenosis based on the combination of morphology and functional information. Magnetic resonance angiography is already able to demonstrate a clinical utility equivalent to that of invasive procedures, indicating that it is likely to become a premier method for the diagnosis and follow up of renovascular disease.

Publication types

  • Review

MeSH terms

  • Angiography, Digital Subtraction
  • Blood Flow Velocity
  • Contrast Media / administration & dosage
  • Forecasting*
  • Gadolinium / administration & dosage
  • Humans
  • Injections, Intravenous
  • Magnetic Resonance Angiography / methods*
  • Magnetic Resonance Angiography / trends
  • Renal Artery / diagnostic imaging
  • Renal Artery / pathology*
  • Renal Artery Obstruction / diagnosis*
  • Renal Artery Obstruction / physiopathology
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Gadolinium