High-spatial-resolution 3D balanced turbo field-echo technique for MR angiography of the renal arteries: initial experience.
PURPOSE: To compare a multislab balanced turbo field-echo magnetic resonance (MR) angiographic technique, without the use of a contrast agent, with digital subtraction angiography (DSA) for imaging of the renal arteries. MATERIALS AND METHODS: Twenty-five randomly selected patients (eight women and 17 men; age range, 27-88 years; mean age, 72 years) suspected of having renal artery stenosis underwent both DSA and balanced turbo field-echo MR angiography. A consensus result was obtained among three radiologists in evaluation of main renal arteries on balanced turbo field-echo images and DSA images. Sensitivity, specificity, and negative and positive predictive values of the balanced turbo field-echo technique were calculated, and receiver operating characteristic analysis was performed for depiction of hemodynamically significant stenosis. Cohen kappa analysis was used to assess agreement between the two imaging methods in grading of stenoses and depiction of significant stenosis. Accessory renal arteries also were evaluated. RESULTS: Fifty main renal arteries and 11 accessory arteries were fully depicted with DSA. DSA depicted 11 stenotic lesions in the main renal arteries. In comparison, balanced turbo field-echo MR angiography enabled visualization of 46 of 50 main renal arteries to their first branching points and depicted 10 of 11 accessory arteries. Sensitivity, specificity, negative predictive value, and positive predictive value of this technique for depiction of significant stenosis were 100% (four of four), 98% (41 of 42), 100% (41 of 41), and 80% (four of five), respectively. The area under the receiver operating characteristic curve was 0.988. kappa was 0.782 for grading of stenoses and 0.877 for depiction of significant stenosis. CONCLUSION: Multislab balanced turbo field-echo imaging has potential as an MR angiography technique for depiction of normal and diseased renal arteries.