Matos C, Metens T, Nicaise N, Golzarian J, Dussaussois L, Struyven J
Service d'Imagerie Médicale, Hôpital Erasme, U.L.B.
Rev Med Brux. 1999 Sep;20(4):A348-51.
Initially, the clinical use of magnetic resonance angiography (MRA) in the abdomen has been restricted because of motion and flow related artifacts. The advent of high performance gradient systems made possible the development of 3D gadolinium-enhanced MRA techniques and expanded the clinical applications of MRA into the abdominal area, particularly for the investigation of renal arteries. This technique is safe, because the administered contrast agent (gadolinium) is free of clinically detectable nephrotoxicity and has a low incidence of allergic reactions. Moreover, contrast MRA also eliminates the risks of ionizing radiation which allows repeating the examination without the accumulation of radiation exposure. The main disadvantages of the technique are its low availability and the fact that the use of contrast agents for this procedure is still not reimbursed by the social security. Many studies demonstrated that contrast MRA allows for the reliable assessment of renal artery morphology and pathologic states. Furthermore, within a single MR examination a comprehensive approach including renal artery morphology, hemodynamic significance of any stenosis and kidney perfusion is available. In this paper, we provide a review of the literature concerning the clinical performance of contrast MRA for the renal arteries and suggest its rationale for the investigation of patients suspected of renovascular disease in our specific environment.
最初,由于运动和流动相关伪影,磁共振血管造影(MRA)在腹部的临床应用受到限制。高性能梯度系统的出现使三维钆增强MRA技术得以发展,并将MRA的临床应用扩展到腹部区域,特别是用于肾动脉的检查。该技术是安全的,因为所使用的造影剂(钆)没有临床可检测到的肾毒性,且过敏反应发生率低。此外,对比增强MRA还消除了电离辐射的风险,这使得可以重复进行检查而不会累积辐射暴露。该技术的主要缺点是其可用性较低,以及该检查使用造影剂仍未被社会保障机构报销。许多研究表明,对比增强MRA能够可靠地评估肾动脉形态和病理状态。此外,在一次磁共振检查中,可以采用综合方法,包括肾动脉形态、任何狭窄的血流动力学意义以及肾脏灌注情况。在本文中,我们对有关肾动脉对比增强MRA临床性能的文献进行综述,并提出在我们特定环境下对疑似肾血管疾病患者进行检查的理论依据。