Renal artery stenosis evaluation: diagnostic performance of gadobenate dimeglumine-enhanced MR angiography--comparison with DSA
| Autor: | Angelo Vanzulli, Jeffrey H. Maki, Miles A. Kirchin, F. K. Schaefer, Richard Coulden, Marek Konopka, Luigi Grazioli, David A. Bluemke, Juan Pablo Niedmann, Martin N. J. M. Wasser, Günther Schneider, Gilles Soulez, Claudio Ballarati, Giovanni Morana, Gianpaolo Pirovano, Mieczyslaw Pasowicz, Giorgio Benea, Philippe Douek, Thomas R. McCauley, Martin R. Prince |
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| Přispěvatelé: | Centre de Recherche et d'Application en Traitement de l'Image et du Signal (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-École Supérieure Chimie Physique Électronique de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Creatis, Compte Général |
| Rok vydání: | 2008 |
| Předmět: |
Male
[INFO.INFO-IM] Computer Science [cs]/Medical Imaging Contrast Media Renal artery stenosis Magnetic resonance angiography Renal Artery [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing ComputingMilieux_MISCELLANEOUS Aged 80 and over [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology medicine.diagnostic_test Middle Aged [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system [INFO.INFO-TI] Computer Science [cs]/Image Processing [eess.IV] [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV] Female [INFO.INFO-MO] Computer Science [cs]/Modeling and Simulation Radiology [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing Adult medicine.medical_specialty Magnetic Resonance Angiography Male Meglumine/*analogs & derivatives/diagnostic use Middle Aged Organometallic Compounds/*diagnostic use Predictive Value of Tests Renal Artery/pathology/radiography Renal Artery Obstruction/*diagnosis/radiography Adolescent [INFO.INFO-TS] Computer Science [cs]/Signal and Image Processing Renal Artery Obstruction Sensitivity and Specificity Meglumine [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system Predictive Value of Tests medicine.artery medicine [INFO.INFO-IM]Computer Science [cs]/Medical Imaging Organometallic Compounds Humans Radiology Nuclear Medicine and imaging Renal artery [SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing Aged business.industry Angiography Digital Subtraction Digital subtraction angiography medicine.disease [INFO.INFO-MO]Computer Science [cs]/Modeling and Simulation Stenosis Angiography business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology Magnetic Resonance Angiography Kidney disease |
| Zdroj: | Radiology Radiology, Radiological Society of North America, 2008, 247 (1), pp.273-85 |
| ISSN: | 1527-1315 0033-8419 |
| Popis: | To prospectively determine diagnostic performance and safety of contrast material-enhanced (CE) magnetic resonance (MR) angiography with 0.1 mmol per kilogram of body weight gadobenate dimeglumine for depiction of significant steno-occlusive disease (or =51% stenosis) of renal arteries, with digital subtraction angiography (DSA) as reference standard.This multicenter study was approved by local institutional review boards; all patients provided written informed consent. Patient enrollment and examination at centers in the United States complied with HIPAA. Two hundred ninety-three patients (154 men, 139 women; mean age, 61.0 years) with severe hypertension (82.2%), progressive renal failure (11.3%), and suspected renal artery stenosis (6.5%) underwent CE MR angiography with three-dimensional spoiled gradient-echo sequences after administration of 0.1 mmol/kg gadobenate dimeglumine at 2 mL/sec. Anteroposterior and oblique DSA was performed in 268 (91.5%) patients. Three independent blinded reviewers evaluated CE MR angiographic images. Sensitivity, specificity, and accuracy of CE MR angiography for detection of significant steno-occlusive disease (or =51% vessel lumen narrowing) were determined at segment (main renal artery) and patient levels. Positive and negative predictive values and positive and negative likelihood ratios were determined. Interobserver agreement was analyzed with generalized kappa statistics. A safety evaluation (clinical examination, electrocardiogram, blood and urine analysis, monitoring for adverse events) was performed.Of 268 patients, 178 who were evaluated with MR angiography and DSA had significant steno-occlusive disease of renal arteries at DSA. Sensitivity, specificity, and accuracy of CE MR angiography for detection of 51% or greater stenosis or occlusion were 60.1%-84.1%, 89.4%-94.7%, and 80.4%-86.9%, respectively, at segment level. Similar values were obtained for predictive values and for patient-level analyses. Few CE MR angiographic examinations (1.9%-2.8%) were technically inadequate. Interobserver agreement for detection of significant steno-occlusive disease was good (79.9% agreement; kappa = 0.69). No safety concerns were noted.CE MR angiography performed with 0.1 mmol/kg gadobenate dimeglumine, compared with DSA, is safe and provides good sensitivity, specificity, and accuracy for detection of significant renal artery steno-occlusive disease. |
| Databáze: | OpenAIRE |
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