Elsevier

Clinical Radiology

Volume 57, Issue 7, July 2002, Pages 617-624
Clinical Radiology

Regular Article
Magnetic Resonance Angiography for the Diagnosis of Renal Artery Stenosis: A Meta-analysis

https://doi.org/10.1053/crad.2002.0941Get rights and content

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% CI: 90–97%) and 85% (95% CI: 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% CI: 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. Tan, K.T. et al. (2002) Clinical Radiology57, 617--624.

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    Author for correspondence and guarantor of study: Dr E. J. R. van Beek, Section of Academic Radiology, Royal Hallamshire Hospital, Floor C, GlossopRoad, Sheffield S10 2JF, U.K. Fax: 0114-2724760; E-mail: [email protected]

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