Parkside Magnetic Resonance Center

3-D Imaging of Renal Arteries

New technologies and techniques in MR continue to transform and expand medical imaging. The Parkside MR Center has been performing in the exciting new area of 3-D imaging of the renal arteries for over a year. Our experience in this area includes assessing patients with hypertension, patients with declining renal function, and kidney transplant patients for renal artery stenosis. Other valuable applications for 3-D imaging of the renal arteries are in the preoperative evaluation of the renal arteries in abdominal aortic aneurysm repair or for renal artery involvement with aortic dissection.

Click on any image below to see an enlargement of that image.

Normal: 63 year old woman with uncontrolled hypertension. (Left) Normal renal MR angiogram. (Right) Magnified view.

Stenosis: 59 year old man with uncontrolled hypertension. Severe left renal artery stenosis.

Unsuspected Mass: 62 year old woman with worsening renal function. (Left) Moderate left renal artery stenosis. (Right) Unsuspected left renal neoplasm.

Transplant Kidney: Declining renal function in a patient with a transplant kidney. (Left) Native and transplant kidney. (Right) Normal transplant renal artery and vein.

Dissection: 52 year old man with severe back pain. (Left) Conventional catheter angiogram demonstrates aortic dissection with partially obstructed flow to the left renal artery. (Right) MRA shows similar findings.

Above images are all original MR scans performed at Parkside MR Center.

Imaging Breakthrough

"As interventional radiologists, we have found Magnetic Resonance Angiography (MRA) to be extremely helpful in the evaluation of patients suspected of having renovascular hypertension. MRA of the renal arteries has become an effective noninvasive screening tool for the detection of renal artery stenosis. We have found this tool to be particularly invaluable in the evaluation of renal arterial disease in patients with limited renal function or a history of contrast allergy. MRA has allowed the interventionalists to select patients suitable for balloon angioplasty without the nephrotoxicity associated with conventional angiography. With the pre-procedural knowledge of the renal vascular anatomy, balloon angioplasty and/or stenting can be performed with a minimal amount of contrast material."

Donatas A. Siliunas, M.D.
Director Angio/Interventional Radiology
Lutheran General Hospital

Discussion

Renal MRA offers a safe and relatively noninvasive method for diagnosing suspected renal stenosis secondary to atherosclerotic disease. Renal artery stenosis is the most common cause of secondary hypertension and is usually treatable by percutanous angioplasty. Multiple studies have shown 100% sensitivity and over 90% specificity for renal MRA in the diagnosis of renal artery stenosis. The studies are performed using breath hold techniques with an I.V. bolus of a gadolinium chelate typically 20-40 cc total contrast load. The base images generated are then reconstructed in a 3-D model for viewing.

At Parkside MRI, three-dimensional renal MRA is combined with a comprehensive MRI examination of the retroperitoneum and includes an assessment of potential renal and adrenal masses. This information can be obtained without the potential nephrotoxic risks of odinated contrast, even in renal failure patients, and without subjecting the patient to arterial catheters and ionizing radiation.

References

1. Dong, Q. Schoenberg S., Carlos, R., Prince M. Renal MR Angiography Seminars in Interventional Radiology 1998;15:163-178

2. Prince, M. Renal MR Angiography: A Comprehensive Approach JMRI 1998;8:511-516

To find out more about 3-D Imaging of Renal Arteries and other services at Parkside MR Center, visit our web site at www.parksidemri.com or call us at (847) 696-7900.

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