Renal arteries: angiography with TOF 3D magnetic resonance with and without contrast media (Gd-DTPA)[Arterie renali: angiografia con Risonanza Magnetica TOF 3D senza e con mezzo di contrasto (Gd-DTPA).]

This work was aimed at investigating the value of Gd-DTPA to demonstrate distal renal artery branches with 3D TOF Magnetic Resonance angiography (MRA). Ten volunteers and two patients with proximal-distal renal artery stenoses were studied with MRA; all subjects were studied before and after Gd-DTPA. MRA was performed with a 1.5-T superconductive magnet (Magnetom Siemens); the FISP 3D sequence was used with the following setting: FA 25 degrees, TR 40 ms, TE 6 ms, slice thickness 64 mm with 64 partitions and MA 256 x 256. This setting was not changed from pre- to post-contrast scans. The images acquired on the z axis were rotated, according to the MIP, on the axial and the sagittal axes, from 0 degrees to 180 degrees, with a 15 degrees step. 0.2 ml/kg of Gd-DTPA were injected as bolus during 3D acquisitions; the injection was started half-way through acquisition. To evaluate and compare pre- and post-contrast MRA images, the signal-to-noise (S/N) ratio and the demonstration of the various renal artery segments were studied. Average S/N ratio was 2.3 in the right renal artery and 2.1 in the left renal artery on pre-contrast MRA images, while it was 0.9 in the left renal artery and 0.8 in the right renal artery on post-contrast MRA images. These differences were statistically significant (p < 0.01). As for the demonstration of the distal segments and of the bifurcations, enhanced MRA was no better than unenhanced MRA. As for the demonstration of distal segment stenoses, enhanced MRA proved no better than unenhanced MRA in both patients. To conclude, in our experience MRA after Gd-DTPA failed to allow the systematic demonstration of the distal segments and of the bifurcations of the renal arteries.