Gadolinium-enhanced breathhold three-dimensional time-of-flight renal MR angiography in the evaluation of potential renal donors

PURPOSE: To evaluate the utility of gadolinium-enhanced three-dimensional ( 3D) time-of-flight (TOF) magnetic resonance angiography (MRA) of the renal arteries in the evaluation of potential renal donors. MATERIALS AND METHODS: Fifty consecutive patients underwent gadolinium-enha nced SD-TOF MRA of the renal arteries as part of their evaluation as possib le renal donors, All imaging was performed on a 1.5-T system with use of a torso phased-array coil. Conventional T1-weighted axial spin-echo and T2-we ighted axial fast spin-echo imaging was performed to evaluate the renal par enchyma, Coronal dynamic MRA was performed during bolus injection of 40 mL of gadolinium with use of a 3D-TOF sequence requiring a breathhold of appro ximately 30 seconds, Maximum-intensity-projection reconstructions were obta ined of the renal arterial and venous anatomy. All studies were prospective ly evaluated by a single radiologist experienced with body MRA. Intraoperat ive findings were used as the reference standard in 35 patients, To evaluat e interobserver variability, each examination was evaluated for image quali ty, renal artery number, and anatomy by two radiologists experienced with M RA and blinded to the other's interpretations and surgical results. RESULTS: Ninety-eight percent of all MRAs were graded as diagnostic quality (Kappa value = 0.38; P < .05). Multiple renal arteries were identified in 29 (29%) of 100 kidneys. Four of 50 patients studied (8%) had renal parench ymal abnormalities identified with MR imaging. Sensitivity and specificity for accessory renal artery detection was 71% and 95%, respectively. Overall , accuracy for MRA in determining renal artery number was 90%, CONCLUSION: Gadolinium-enhanced breathhold 3D-TOF renal MRA is sufficient t o assess the renal arteries in potential donors.