RENAL-CANCER - PREOPERATIVE EVALUATION WITH DUAL-PHASE 3-DIMENSIONAL MR-ANGIOGRAPHY

PURPOSE: To evaluate the use of dual-phase three-dimensional magnetic resonance (MR) angiography in the preoperative staging of renal cancer . MATERIALS AND METHODS: MR angiography was performed in 18 patients b efore performance of partial (n = 7), radical (n = 10), or laparoscopi c (n = 1) nephrectomy to treat renal canter. Dynamic, three-dimensiona l MR angiograms were obtained with gadoteridol enhancement breath hold ing, and a three-dimensional spoiled gradient-echo sequence. Images we re obtained at 15-second intervals to achieve opacification of arterie s and veins. Source, maximum intensity projection, and multiplanar rec onstruction images were evaluated. Imaging results were compared with surgical findings. RESULTS: Renal arterial phase MR angiograms depicte d 30 of 31 (97%) surgically confirmed renal arteries, with one false-p ositive result (an artery that arose from an early-branching single ma in renal artery, interpreted as a separate accessory artery). Renal ve nous phase MR angiograms depicted all seven instances of renal vein in volvement, including extension to the inferior vena cava in two patien ts. Collateral vessels around the tumor, including prominent gonadal v eins in three patients, were demonstrated. Additional findings include d adenopathy and adrenal and pulmonary metastases. CONCLUSION: Dual-ph ase MR angiography of the kidney may be a useful technique in depictin g renal vessels before nephrectomy.