Comprehensive MR evaluation of renovascular disease in five breath holds

To detect a renal artery stenosis and assess its hemodynamic and functional significance in five breath holds. In a single MR exam. T1 weighted FLASH and T2 weighted fast spin echo techniques are used to assess renal morpholo gy, multiphase 3D gadolinium (Gd) MRA to evaluate the renal arteries, and a segmented EPI cine phase-contrast technique to measure renal artery blood now, A standardized image analysis is performed to assess kidney size, cort ico-medullar differentiation (CMD), parenchymal enhancement, the degree of renal artery stenosis, abnormalities in blood now pattern, and any associat ed abdominal vascular disease. Multiphase 3D-Gd-MRA accurately assesses ath erosclerotic renal artery disease particularly in the presence of an associ ated aortic aneurysm. Delayed parenchymal enhancement, loss of CMD, and dec rease in kidney size can be detected. In combination with decreased systoli c velocity components, the diagnosis of a hemodynamically and functionally significant stenosis can be made. High-resolution single-phase 3D-Gd-MRA is preferable for evaluation of fibromuscular dysplasia or hypoplastic vessel s. The combination of different breath hold techniques in a single, standar dized MR exam allows to detect the hemodynamic and functional significance of a renal artery stenosis, (C) 1999 Wiley-Liss, Inc.