Rotem Shlomo Lanzman MD, Presenter: Nothing to Disclose

Clemens Walther, Abstract Co-Author: Nothing to Disclose

Adrian Stefan Ringelstein MD, Abstract Co-Author: Nothing to Disclose

Frank Schellhammer, Abstract Co-Author: Nothing to Disclose

Sonja-Marie Freitag, Abstract Co-Author: Nothing to Disclose

Karl-Heinz Truemmler, Abstract Co-Author: Nothing to Disclose

Axel Scherer MD, Abstract Co-Author: Nothing to Disclose

Adina Voiculescu, Abstract Co-Author: Nothing to Disclose

Dirk Blondin MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To assess the diagnostic value of a nonenhanced SSFP MR Angiography for postoperative imaging of transplant renal arteries.

Transplant renal arteries (n=15) of 15 recipients with a pathologic flow profile in duplex sonography were imaged with an ECG-gated NATIVE Steady-State Free Precession MR Angiography (Siemens, Erlangen, G) using a 1.5 T MR Scanner and with conventional DSA. The SSFP sequence consists of a selective inversion prepulse with an inversion time automatically adjusted to the RR interval. MR images were analysed independently by two radiologists blinded to the patient data and results of conventional DSA.

In one patient NATIVE SSFP MR Angiography failed to visualize the transplant renal artery due to low cardiac output. In 14 patients NATIVE SSFP MRA revealed an excellent signal of arterial structures up to renal segment branches. In these 14 patients, DSA disclosed stenosis of the iliac artery (n=6), kinking of the transplant renal artery (n=6) and high grade stenosis of segment arteries (n=2). As compared to DSA, SSFP MRA showed a sensitivity of 100%, a specifity of 87,5 % and an accuracy of 92,9 %. SSFP MRA determined the degree of low (n=4) and medium grade (n=2) stenosis correctly, while high grade stenosis (n=2) were overestimated due to severe signal loss distal the stenotic lesion.

In terms of nephrogenic systemic fibrosis (NSF), nonenhanced MRA techniques are gaining progredient importance. ECG-gated NATIVE SSFP MR Angiography enables reliable imaging of postoperative transplant renal arteries. However, this technique tends to overestimate significant stenosis and shows poor vascular contrast in patients with low cardiac output. Therefore, further studies are mandatory.

ECG-gated nonenhanced SSFP MR Angiography allows reliable assessment of renal transplant arteries and can therefore be applied as a save screening method for stenosis in transplant recipients.

Lanzman, R, Walther, C, Ringelstein, A, Schellhammer, F, Freitag, S, Truemmler, K, Scherer, A, Voiculescu, A, Blondin, D, et al, , ECG-gated Non-enhanced Steady-State Free Precession (SSFP) MR Angiography (MRA) in Assessment of Transplant Renal Arteries: Comparison with Digital Subtraction Angiography (DSA).  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6012463.html