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Diagnostic performance of a non-contrast-enhanced magnetic resonance imaging protocol for potential living related kidney donors


Goetti, Robert; Baumueller, Stephan; Alkadhi, Hatem; Clavien, Pierre-Alain; Schiesser, Marc; Pfammatter, Thomas; Hunziker, Roger; Puippe, Gilbert (2013). Diagnostic performance of a non-contrast-enhanced magnetic resonance imaging protocol for potential living related kidney donors. Academic Radiology, 20(4):393-400.

Abstract

RATIONALE AND OBJECTIVES: The objective of the study was to evaluate the performance of a non-contrast-enhanced magnetic resonance (MR) imaging protocol for preoperative screening of living related kidney donors.
MATERIALS AND METHODS: Forty consecutive subjects (mean age 52.2 ± 11.3 years, range 29-73 years) underwent MR imaging with T2-weighted sequences (coronal and axial plane), with a non-contrast-enhanced respiratory-gated three-dimensional steady state free precession MR angiography (NCE-MRA) sequence and with contrast-enhanced magnetic resonance MR angiography (CE-MRA) sequences in the arterial and venous phases. Two blinded readers independently assessed arterial and venous anatomy and potential kidney lesions. Results of non-contrast-enhanced images were compared to CE-MRA and in a subgroup of 21 subjects to surgery as standard of reference.
RESULTS: Regarding arterial anatomy, NCE-MRA yielded sensitivity, specificity, and accuracy of 100%, 89%, and 91% compared to CE-MRA. Three kidneys were found to have more accessory renal arteries at NCE-MRA than at CE-MRA. In the subgroup of 21 subjects, 1 surgically proven accessory artery was depicted with NCE-MRA but not with CE-MRA. Accuracy of T2-weighted images regarding accessory veins or variant venous course was 99%, with one missed circumaortic vein on T2-weighted images. Two simple cysts were missed on T2-weighted and NCE-MRA but not on CE-MRA images.
CONCLUSION: A non-contrast-enhanced MR imaging protocol including NCE-MRA and T2-weighted images allows for the accurate screening of living related kidney donors and may serve as an alternative to CE-MRA.

Abstract

RATIONALE AND OBJECTIVES: The objective of the study was to evaluate the performance of a non-contrast-enhanced magnetic resonance (MR) imaging protocol for preoperative screening of living related kidney donors.
MATERIALS AND METHODS: Forty consecutive subjects (mean age 52.2 ± 11.3 years, range 29-73 years) underwent MR imaging with T2-weighted sequences (coronal and axial plane), with a non-contrast-enhanced respiratory-gated three-dimensional steady state free precession MR angiography (NCE-MRA) sequence and with contrast-enhanced magnetic resonance MR angiography (CE-MRA) sequences in the arterial and venous phases. Two blinded readers independently assessed arterial and venous anatomy and potential kidney lesions. Results of non-contrast-enhanced images were compared to CE-MRA and in a subgroup of 21 subjects to surgery as standard of reference.
RESULTS: Regarding arterial anatomy, NCE-MRA yielded sensitivity, specificity, and accuracy of 100%, 89%, and 91% compared to CE-MRA. Three kidneys were found to have more accessory renal arteries at NCE-MRA than at CE-MRA. In the subgroup of 21 subjects, 1 surgically proven accessory artery was depicted with NCE-MRA but not with CE-MRA. Accuracy of T2-weighted images regarding accessory veins or variant venous course was 99%, with one missed circumaortic vein on T2-weighted images. Two simple cysts were missed on T2-weighted and NCE-MRA but not on CE-MRA images.
CONCLUSION: A non-contrast-enhanced MR imaging protocol including NCE-MRA and T2-weighted images allows for the accurate screening of living related kidney donors and may serve as an alternative to CE-MRA.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Visceral and Transplantation Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:21 Mar 2013 10:13
Last Modified:05 Apr 2016 16:42
Publisher:Elsevier
ISSN:1076-6332
Publisher DOI:https://doi.org/10.1016/j.acra.2012.12.001
PubMed ID:23498978

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