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

doi:10.1053/crad.2002.0941

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

Deanery of Clinical Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

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 language	English
Pages (from-to)	617-624
Number of pages	8
Journal	Clinical Radiology
Volume	57
Issue number	7
DOIs	https://doi.org/10.1053/crad.2002.0941
Publication status	Published - 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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10.1053/crad.2002.0941

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@article{786581c2b1634aada8964a9470e2f421,

title = "Magnetic resonance angiography for the diagnosis of renal artery stenosis: A meta-analysis",

abstract = "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",

keywords = "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",

author = "KT Tan and {Van Beek}, EJR and PWG Brown and {Van Delden}, OM and J Tijssen and LE Ramsay",

year = "2002",

month = jul,

doi = "10.1053/crad.2002.0941",

language = "English",

volume = "57",

pages = "617--624",

journal = "Clinical Radiology",

issn = "0009-9260",

publisher = "W.B. Saunders Company",

number = "7",

}

TY - JOUR

T1 - Magnetic resonance angiography for the diagnosis of renal artery stenosis

T2 - A meta-analysis

AU - Tan, KT

AU - Van Beek, EJR

AU - Brown, PWG

AU - Van Delden, OM

AU - Tijssen, J

AU - Ramsay, LE

PY - 2002/7

Y1 - 2002/7

N2 - 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

AB - 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

KW - hypertension

KW - renal artery

KW - diagnosis

KW - MRI

KW - gadolinium

KW - meta-analysis

KW - CONTRAST MR-ANGIOGRAPHY

KW - TIME-OF-FLIGHT

KW - DIGITAL SUBTRACTION ANGIOGRAPHY

KW - PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY

KW - SINGLE-BREATH HOLD

KW - RENOVASCULAR HYPERTENSION

KW - ABDOMINAL-AORTA

KW - 1.0 T

KW - DISEASE

KW - ACCURACY

U2 - 10.1053/crad.2002.0941

DO - 10.1053/crad.2002.0941

M3 - Article

SN - 0009-9260

VL - 57

SP - 617

EP - 624

JO - Clinical Radiology

JF - Clinical Radiology

IS - 7

ER -

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

Abstract

Keywords / Materials (for Non-textual outputs)

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