NONINVASIVE ANGIOGRAPHY IN PREOPERATIVE EVALUATION OF COMPLICATED PEDIATRIC RENAL MASSES USING PHASE-CONTRAST MAGNETIC-RESONANCE ANGIOGRAPHY

Objectives. To report a new technique called ''phase contrast magnetic resonance angiography'' (PC MRA) utilizing phase contrast magnetic re sonance imaging, for assessing the renal vasculature in relation to co mplicated pediatric renal masses. Methods. Three-dimensional phase con trast gradient refocused pulse sequences were obtained on four pediatr ic patients with complicated renal masses. Findings were compared to u ltrasound and computed tomographic images and correlated with actual s urgical anatomy. Results. In all four cases PC MRA provided standard a ngiographic quality detail of the renal vascular anatomy. The PC MRA f indings had a 100% correlation with surgical exploration and MRA prove d to be approximately one third the cost of the standard angiographic technique. Conclusions. Our experience with the use of PC MRA in child ren suggests that it can be helpful in evaluating the vasculature of c omplicated pediatric renal masses. PC MRA utilizes current generation magnetic resonance units, is noninvasive, and does not require anesthe sia. It may be especially useful in patients with hypersensitivity to contrast agents, in those with renal failure in whom contrast agents m ay be contraindicated, and is less expensive than standard angiography .