Two-dimensional time-of-flight magnetic resonance angiography of renal arteries without maximum intensity projection: a prospective comparison with angiography in 21 patients screened for renovascular hypertension.

PURPOSE: We compared magnetic resonance angiography (MRA) with conventional angiography to establish its value as a screening test in the workup for renal hypertension.

METHODS

Twenty-one patients underwent MRA and angiography within a three-day interval. Fifteen patients were suspected of having renovascular hypertension on the basis of clinical findings; the remaining six had multivessel atherosclerosis with renal insufficiency. MRA was performed on a 1 Tesla magnet in three planes: axial, coronal and perpendicular to the axis of each renal artery, by means of several contiguous or overlapping individual slice acquisitions. The two examinations were read by the same two independent observers, before and after an interval of 3 months.

RESULTS

Conventional angiography showed 48 renal arteries. All main and three of six accessory renal arteries were correctly identified by MRA, as well as 11 of 14 significant stenoses or thromboses. Overreading of stenoses by MRA was observed in 4 cases. There were two false negatives for the two readers. The sensitivity and specificity of MRA for the detection of stenoses of the main renal arteries were found to be 70 and 78% respectively, for the first reading and 85 and 86% for the second reading.

CONCLUSION

MRA is considered a useful noninvasive method to determine the need for conventional angiography in patients in whom renal artery stenosis is suspected.