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(Radiology. 1999;210:367-372.)
© RSNA, 1999


Vascular and Interventional Radiology

Renal Artery Stenosis: Evaluation with Conventional Angiography versus Gadolinium-enhanced MR Angiography

Maryellyn Gilfeather, MD1, Hyo-Chun Yoon, MD, PhD1, Evan S. Siegelman, MD2, Leon Axel, MD, PhD2, Alan H. Stolpen, MD, PhD2, Richard D. Shlansky-Goldberg, MD2, Richard A. Baum, MD2, Michael C. Soulen, MD2 and Mitchell D. Schnall, MD, PhD2

1 Department of Radiology, University of Utah Health Sciences Center, 50 N Medical Dr, Salt Lake City, UT 84132 (M.G., H.C.Y.)
2 Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia (E.S.S., L.A., A.H.S., R.D.S.G., R.A.B., M.C.S., M.D.S.).

PURPOSE: To evaluate the interobserver and intermodality variability of conventional angiography and gadolinium-enhanced magnetic resonance (MR) angiography in the assessment of renal artery stenosis.

MATERIALS AND METHODS: Fifty-four patients underwent conventional angiography and gadolinium-enhanced three-dimensional gradient-echo MR angiography. Three angiographers blinded to each other's interpretations and the MR angiographic findings assessed the conventional angiograms for renal artery stenosis. Similarly, three blinded MR imagers evaluated the MR angiograms.

RESULTS: Interobserver variability for the degree of renal artery stenosis in the 107 kidneys evaluated was not significantly different between the two modalities. The mean SD of the degree of stenosis was 6.9% at MR angiography versus 7.5% at conventional angiography ({alpha} <= .05, P > .05). In 70 kidneys (65%), the average degree of stenosis reported by the readers for the two modalities differed by 10% or less. In 22 cases (21%), the degree of stenosis was overestimated with MR angiography by more than 10% relative to the results of conventional angiography. In 15 cases (14%), the degree of stenosis was underestimated with MR angiography by more than 10%.

CONCLUSION: Gadolinium-enhanced MR angiography permits evaluation of renal artery stenosis with an interobserver variability comparable with that of conventional angiography.

Index terms: Angiography, comparative studies, 961.122 • Magnetic resonance (MR), comparative studies, 961.12942, 961.12943 • Magnetic resonance (MR), vascular studies, 961.12942, 961.12943 • Renal arteries, stenosis or obstruction, 961.721




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