Magnetic resonance angiography for the diagnosis of renal artery stenosis: A meta-analysis

KT Tan, EJR Van Beek*, PWG Brown, OM Van Delden, J Tijssen, LE Ramsay

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

AIM: To review the published literature comparing the diagnostic accuracy of magnetic resonance angiography (MRA) with and without gadolinium in diagnosing renal artery stenosis, using catheter angiography as reference.

MATERIALS AND METHODS: A meta-analysis was performed of English language articles identified by computer search using PubMed/MEDLINE, followed by extensive bibliography review from 1985 to May 2001. Inclusion criteria were: (1) blinded comparison with catheter angiography; (2) indication for MRA stated; (3) clear descriptions of imaging techniques; and (4) interval between MRA and catheter angiography <3 months and only the largest of all studies from one centre was selected in the analysis.

RESULTS: A total of 39 studies were identified, of which 25 met the inclusion criteria. The number of patients included in the meta-analysis was 998: 499 with non-enhanced MRA and 499 with gadolinium-enhanced MRA. The sensitivity and specificity of non-enhanced MRA were 94% (95% Cl: 90-97%) and 85% (95% Cl: 82-87%), respectively. For gadolinium-enhanced MRA sensitivity was 97% (95% CI: 93-98%) and specificity was 93% (95% CI: 91-95%). Thus, specificity and positive predictive value were significantly better for gadolinium-enhanced MRA (P <0.001). Accessory renal arteries were depicted better by gadolinium-enhanced MRA (82%; 95% CI: 75-87%) than non-gadolinium MRA (49%; 95% Cl: 42-60%) (P <0.001).

CONCLUSIONS: Gadolinium-enhanced MRA may replace arteriography in most patients with suspected renal artery stenosis, and has major advantages in that it is non-invasive, avoids ionizing radiation and uses a non-nephrotoxic contrast agent. (C) 2002 The Royal College of Radiologists

Original languageEnglish
Pages (from-to)617-624
Number of pages8
JournalClinical Radiology
Volume57
Issue number7
DOIs
Publication statusPublished - Jul 2002

Keywords / Materials (for Non-textual outputs)

  • hypertension
  • renal artery
  • diagnosis
  • MRI
  • gadolinium
  • meta-analysis
  • CONTRAST MR-ANGIOGRAPHY
  • TIME-OF-FLIGHT
  • DIGITAL SUBTRACTION ANGIOGRAPHY
  • PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY
  • SINGLE-BREATH HOLD
  • RENOVASCULAR HYPERTENSION
  • ABDOMINAL-AORTA
  • 1.0 T
  • DISEASE
  • ACCURACY

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