Comparison of contrast enhanced MR-angiography-MRI and digital subtractionangiography in the evaluation of pancreas and/or kidney transplantation patients: initial experience

To evaluate whether combined contrast enhanced MRA and MRI (ce-MRA-MRI) has the potential to replace intra-arterial DSA (i.a.DSA) in patients with imp aired graft function or suspected of vascular complications after pancreas and/or kidney transplantation. 7 patients after combined pancreas-kidney and 22 patients after kidney tran splantation underwent ce-MRA-MRI and i.a.DSA within a 3 days interval. Qual itative and quantitative comparison of the arterial and venous supply, the parenchyma and urinary collecting system was made. Both ce-MRA and i.a.DSA showed good results in the detection of arterial st enoses. However, ce-MRA falsely suggested stenoses if vascular clips were u sed; on the other hand, i.a.DSA was less informative if the graft arteries were very tortuous. Ce-MRA was superior in depicting the venous anatomy (p < 0.001) and the parenchymal enhancement of the pancreatic grafts. For the assessment of the contrast excretion, the pyelocalyceal system and the uret er of the renal graft ce-MRA-MRI was superior (p < 0.001), for small calibe r arteries in the renal grafts i.a.DSA was of greater value (p < 0.001). The combination of ce-MRA and MRI is reliable for evaluating the vascular a natomy and has several advantages over i.a.DSA after pancreas and/or kidney transplantation. It can replace i.a.DSA in patients with impaired graft fu nction or suspected of vascular complications after pancreas and/or kidney transplantation. (C) 2001 Elsevier Science Inc. All rights reserved.