(Hypertension. 1999;33:726-731.)
© 1999 American Heart Association, Inc.
Scientific Contribution |
Magnetic Resonance Angiography Versus Duplex Sonography for Diagnosing Renovascular Disease
From the Department of Internal Medicine, Angiology Division (U.H., L.R., E.S.), and Institute of Diagnostic Radiology (D.A.L., T.P., T.F.H., P.H., G.G.Z.-P., J.F.D.), Zürich University Hospital, Zürich, Switzerland.
Correspondence to Jörg F. Debatin, MD, Institute of Diagnostic Radiology, Zürich University Hospital, Rämistr. 100, CH-8091 Zürich, Switzerland. E-mail debatin{at}dmr.usz.ch
Abstract—Noninvasive testing for
renovascular disease is required to identify patients who may benefit
from revascularization procedures without exposing
an unnecessary amount of patients to the risks of catheter angiography.
All available methods of diagnosing renal artery stenosis have
significant limitations. We compared a new technique, contrast-enhanced
magnetic resonance angiography, with an established technique, duplex
ultrasonography, for the detection of renal artery stenosis
using catheter angiography as the standard of reference. Eighty-nine
patients with clinically suspected renovascular disease underwent
duplex renal scanning and contrast-enhanced magnetic resonance
angiography. Sixty of these also underwent catheter angiography. All
studies were interpreted for the presence of renal artery
stenosis blinded to the results of the other imaging
modalities. For detection of hemodynamically
significant (
60% diameter reduction) main renal artery
stenosis, sensitivity and specificity were 90% and 86%,
respectively, for magnetic resonance angiography and 81% and 87% for
duplex sonography. Most false readings involved differential grading of
stenoses detected with all 3 techniques. When patients with
fibromuscular dysplasia were excluded from the analysis, the
sensitivity of magnetic resonance angiography increased to 97%, with a
negative predictive value of 98%. Magnetic resonance angiography
detected 96% and duplex 5% of accessory renal arteries seen at
catheter angiography. Contrast-enhanced magnetic resonance angiography
is a useful technique for diagnosing atherosclerotic renovascular
disease. It overcomes the major limitations of duplex renal scanning.
However, duplex has the advantage of providing
hemodynamic information and appears better suited for
the assessment of patients with suspected fibromuscular dysplasia.
Key Words: arteries • hypertension, renovascular • magnetic resonance imaging • renal artery obstruction • ultrasound
This article has been cited by other articles:
 |
|
 |
|
  B. Drieghe, J. Madaric, G. Sarno, G. Manoharan, J. Bartunek, G. R. Heyndrickx, N. H.J. Pijls, and B. De Bruyne Assessment of renal artery stenosis: side-by-side comparison of angiography and duplex ultrasound with pressure gradient measurements Eur. Heart J., February 2, 2008; 29(4): 517 - 524. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. J. Williams, P. Macaskill, S. F. Chan, T. E. Karplus, W. Yung, E. M. Hodson, and J. C. Craig Comparative Accuracy of Renal Duplex Sonographic Parameters in the Diagnosis of Renal Artery Stenosis: Paired and Unpaired Analysis Am. J. Roentgenol., March 1, 2007; 188(3): 798 - 811. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S J Gandy, K Armoogum, R S Nicholas, T B McLeay, and J G Houston A clinical MRI investigation of the relationship between kidney volume measurements and renal function in patients with renovascular disease Br. J. Radiol., January 1, 2007; 80(949): 12 - 20. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Nael, R. Saleh, M. Lee, T. McNamara, S. R. Godinez, G. Laub, J. P. Finn, and S. G. Ruehm High-spatial-resolution contrast-enhanced MR angiography of abdominal arteries with parallel acquisition at 3.0 T: initial experience in 32 patients. Am. J. Roentgenol., July 1, 2006; 187(1): W77 - W85. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. E. Zierler Atherosclerotic Renovascular Disease: Natural History and Diagnosis Perspectives in Vascular Surgery and Endovascular Therapy, December 1, 2004; 16(4): 299 - 310. [Abstract] [PDF]
|
|
|
|
 |
|
 C. K. Guill, D. C. Benavides, C. Rees, A. Z. Fenves, and E. C. Burton Fatal Mesenteric Fibromuscular Dysplasia: A Case Report and Review of the Literature Arch Intern Med, May 24, 2004; 164(10): 1148 - 1153. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Gowda, A. L. Loeb, L. J. Crouse, and P. H. Kramer Complementary roles of color-flow duplex imaging and intravascular ultrasound in the diagnosis of renal artery fibromuscular dysplasia: Should renal arteriography serve as the "gold standard"? J. Am. Coll. Cardiol., April 16, 2003; 41(8): 1305 - 1311. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. G. Turi and M. R. Jaff Renal artery stenosis: searching for the algorithms for diagnosis and treatment J. Am. Coll. Cardiol., April 16, 2003; 41(8): 1312 - 1315. [Full Text] [PDF]
|
|
|
|
 |
|
 J. K. Willmann, S. Wildermuth, T. Pfammatter, J. E. Roos, B. Seifert, P. R. Hilfiker, B. Marincek, and D. Weishaupt Aortoiliac and Renal Arteries: Prospective Intraindividual Comparison of Contrast-enhanced Three-dimensional MR Angiography and Multi-Detector Row CT Angiography Radiology, March 1, 2003; 226(3): 798 - 811. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. M. Bossuyt, J. B. Reitsma, D. E. Bruns, C. A. Gatsonis, P. P. Glasziou, L. M. Irwig, D. Moher, D. Rennie, H. C.W. de Vet, and J. G. Lijmer The STARD Statement for Reporting Studies of Diagnostic Accuracy: Explanation and Elaboration Ann Intern Med, January 7, 2003; 138(1): W1 - W12. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. M. Bossuyt, J. B. Reitsma, D. E. Bruns, C. A. Gatsonis, P. P. Glasziou, L. M. Irwig, D. Moher, D. Rennie, H. C.W. de Vet, and J. G. Lijmer The STARD Statement for Reporting Studies of Diagnostic Accuracy: Explanation and Elaboration Clin. Chem., January 1, 2003; 49(1): 7 - 18. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Spinosa, A. H. Matsumoto, J. F. Angle, K. D. Hagspiel, D. Cage, E. A. Bissonette, K. G. Koenig, C. R. Ayers, and K. McConnell Safety of CO2- and Gadodiamide-Enhanced Angiography for the Evaluation and Percutaneous Treatment of Renal Artery Stenosis in Patients with Chronic Renal Insufficiency Am. J. Roentgenol., May 1, 2001; 176(5): 1305 - 1311. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R G Woolfson Renal failure in atherosclerotic renovascular disease: pathogenesis, diagnosis, and intervention Postgrad. Med. J., February 1, 2001; 77(904): 68 - 74. [Full Text]
|
|
|
|
 |
|
 S. D. Sarkar, D. N. Siegel, G. Soulez, and V. L. Oliva Invited Commentary Authors' Response RadioGraphics, September 1, 2000; 20(5): 1368 - 1372. [Full Text] [PDF]
|
|
|
|
|
|
D. Weishaupt, S. G. Ruhm, C. A. Binkert, M. Schmidt, M. A. Patak, F. Steybe, S. McGill, and J. F. Debatin Equilibrium-Phase MR Angiography of the Aortoiliac and Renal Arteries Using a Blood Pool Contrast Agent Am. J. Roentgenol., July 1, 2000; 175(1): 189 - 195. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. G. Ruehm, T. F. Hany, T. Pfammatter, E. Schneider, M. Ladd, and J. F. Debatin Pelvic and Lower Extremity Arterial Imaging: Diagnostic Performance of Three-Dimensional Contrast-Enhanced MR Angiography Am. J. Roentgenol., April 1, 2000; 174(4): 1127 - 1135. [Abstract] [Full Text] [PDF]
|
|