Purpose: The assessment of vascular complications by DSA in patients who have undergone kidney and pancreas transplantation is an invasive investigation and has the risk of nephrotoxicity caused by the iodinated contrast agent. The aim of this study was to compare the diagnostic value of noninvasive gadolinium--enhanced MRA with intraoperative and DSA results.
Patients and methods: Eleven MRA investigations were performed in eight patients after kidney and pancreas transplantation. A fast T1-weighted 3D-gradient-echo sequence with short TR and TE was used in a dynamic technique including the three consecutive data acquisitions after a Gd-DTPA (Magnevist) injection. MRA was compared with intraoperative findings in all patients and with DSA in three patients.
Results: In the distal abdominal aorta, the internal and external iliac arteries, the main transplanted arterial vessels, and the arteries after first branching, high signal intensity was found. Assessment of renal and pancreatic parenchyma perfusion was possible in all patients. Venous transplant vessels could be depicted in four patients.
Conclusion: Our initial experience with the MRA sequence used shows that this technique may be promising in the assessment of larger arterial transplanted vessels and kidney/pancreas parenchyma perfusion. Improvement of the MRA technique is necessary for transplanted venous vessels.