3D FIESTA pulse sequence for assessing renal artery stenosis: is it a reliable application in unenhanced magnetic resonance angiography?

Eur Radiol. 2014 Dec;24(12):3042-50. doi: 10.1007/s00330-014-3330-7. Epub 2014 Jul 25.

Abstract

Objectives: To assess the capability of the three-dimensional (3D) Fast Imaging Employing Steady-State Acquisition (FIESTA) sequence in evaluating renal artery stenosis (RAS).

Methods: We retrospectively analysed 79 patients referred for suspected RAS, examined by 3D FIESTA and contrast-enhanced magnetic resonance angiography (CE-MRA), using a 1.5T whole-body scanner. Image quality was assessed as well as the presence and grade of RAS. Patients with RAS ≥ 50% were evaluated for possible digital subtraction angiography (DSA). Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of 3D FIESTA were calculated with ROC analysis using CE-MRA and DSA as the standard of reference.

Results: A total of 186 renal arteries were assessed; 36 had RAS ≥ 50 % demonstrated by CE-MRA. Ten patients underwent DSA, for a total evaluation of 22 arteries. Sensitivity, specificity, NPV, PPV, and accuracy of 3D FIESTA were 91.7%, 100%, 98%, 100%, and 98%, respectively, as compared to CE-MRA, and 88.2%, 100%, 71.4%, 100%, and 91%, respectively, as compared to DSA. The area under the ROC curve (AUC) of 3D FIESTA as compared to CE-MRA and DSA was 0.958 and 0.941, respectively.

Conclusions: Our study demonstrated the capability of the 3D FIESTA sequence in evaluating RAS, with high-quality images and good diagnostic accuracy.

Key points: The 3D FIESTA sequence provides a robust evaluation of RAS. The 3D FIESTA sequence allows non-invasive evaluation of the renal arteries. The 3D FIESTA sequence could be a useful tool in evaluating RAS.

Publication types

  • Evaluation Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography, Digital Subtraction / methods
  • Contrast Media
  • Epidemiologic Methods
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods
  • Magnetic Resonance Angiography / methods*
  • Male
  • Middle Aged
  • Renal Artery Obstruction / diagnosis*
  • Young Adult

Substances

  • Contrast Media