Comparision of contrast enhanced mr angiography versus digital subtraction angiography in renal artery stenosis

Renal artery stenosis (RAS) is the most common cause of secondary hypertension. The main causes of renal artery stenosis are atherosclerosis and fibromuscular dysplasia and, less commonly arteritis and arterial thrombosis. RAS may cause renal insufficiency, uncontrolled hypertension and is associated with increased cardiovascular morbidity and mortality. The incidence of RAS appears to be rising because of increased atherosclerosis in an aging population. At the same time, revascularization techniques have also evolved and most renal artery revascularization is now performed percutaneously. After the recent technical developments, magnetic resonance angiography (MRA) has become the most preferable noninvasive imaging modality for determining the changes in aorta and renal arteries. The aim of this study is evoluate the accuracy of contrast enhanced Flash 3D Renal MRA in the depiction of the RAS also detecting of accessory and polar renal arteries with intraarterial digital subtraction angiography (DSA) still serving as the reference standard. We retrospectively reviewed contrast enhanced Flash 3D Renal MRA and DSA of 71 patients who had suspected RAS and underwent DSA after MRA within 15 days retrospectively. DSA was accepted as gold standart and the specificity, sensitivity and accuracy of MRA were determined. Also risk factors, symptoms, main diseases were noted. Overall sensitivity and specificity values of contrast enhanced Flash 3D Renal MRA in detecting stenosis were 96,1%and 76,3%respectively. Accessory renal arteries and polar renal arteries demonstrated with DSA are also detected with contrast enhanced Flash 3D Renal MRA with a ratio 79,7%and 59,8 % respectively. In conclusion, contrast enhanced Flash 3D Renal MRA is a reliable noninvasive imaging modality in the diagnosis of RAS. Key Words: Renal artery stenosis, magnetic resonance angiography, digital subtraction angiography.