Keywords:
Kidney, Vascular, Arteries / Aorta, CT-Angiography, MR-Angiography, Imaging sequences, Stents, Arteriosclerosis, Hypertension, Obstruction / Occlusion
Authors:
E. Esteban García1, V. Garcia Medina2, J. García Medina2, M. I. Moya García1, D. Pérez Flores2; 1Torrevieja/ES, 2murcia/ES
DOI:
10.26044/ecr2019/C-1419
Results
In our study,
there is a good agreement between both techniques for the degree of stenosis in the ostium/proximal part of the renal arteries (kappa: 0.79).
Sensitivity,
specificity,
positive predictive value and negative predictive value are 89%,
99%,
89% and 99%,
respectively.
The evaluation of the distal part of the artery is limited with the ARM-TOF (sensitivity,
specificity,
positive predictive value and negative predictive value are 66,7%,
98,18%,
50% and 99%,
respectively).
When the stenosis is < 60%,
there is a small difference between both techniques and both observers with regard to quantification of stenosis degree,
which isn’t clinically relevant.
(Fig.
1,
2 and 3)
When the stenosis is > 60% there is a signal loss in the stenosis and the signal reappears distal to the stenosis.
(Fig.
4 and 5)
9 renal arteries have positive findings for significant stenosis identified by CTA and only one of them is not identified with the TOF-MRA.
There is one false positive case,
due to an anatomical variation: the origin of the renal artery is on the anterior side of the aorta with a caudal-to-craneal direction,
so the artery is not perpendicular to the plane of acquisition and the signal is suppressed.
(Fig.
6)
CTA images have detected 3 patients with two left main renal arteries and three with two right renal arteries.
The inferior renal artery of 3 of these patients is not assessable with the TOF-MRA because they are not included in the FOV.