Phase-contrast MR angiography for detection of arteriosclerotic renal artery stenosis

Purpose: To compare the accuracy of 3-D phase-contrast (PC) MR imaging with a 2-D time-of-flight (TOF) technique in the detection of arteriosclerotic renal artery stenosis. Material and Methods: Twenty-two patients with 28 angiographically proven renal artery stenoses were examined in a prospective blinded fashion by using 2-D TOF MR angiography (MRA) with venous saturation (FLASH) and 3-D PC MRA. The renal arteries were subdivided into 3 segments and graded for the presence of stenoses on a scale of 0-4 by 3 radiologists in blind. Results: The accuracy of TOF and PC imaging in detecting renal artery stenoses was 65% and 77% respectively. Both 2-D TOF and 3-D PC MRA depicted 84% of the stenoses of the proximal renal artery greater than 50% in diameter. Renal artery stenoses greater than 50% and more than 15 mm in distance from the aorta were detected in 40% of cases with the 2-D TOF sequence and in 76% with the 3-D PC technique (p<0.05). The rate of false-negative results was 32%. Conclusion: PC MRA is better at visualizing stenoses in the middle segment of the renal arteries and supplements conventional TOF techniques with additional information. However, even when the two techniques are combined, the false-negative rate in the MR imaging of stenoses of the renal arteries still needs to be reduced.