Kuhlemann J, Blondin D, Grotemeyer D, Zgoura P, Reichelt D, Heinen W, Scherer A, Lanzman R S
Institut für Radiologie, Uniklinikum Düsseldorf.
Rofo. 2010 Nov;182(11):1001-9. doi: 10.1055/s-0029-1245685. Epub 2010 Oct 4.
The purpose of this study was to evaluate the blood pool contrast agent gadofosveset for MR angiography (MRA) of the renal vasculature in living kidney donors (LKD).
Of the 28 consecutive potential LKDs (13 men, 15 women; mean age 55.14 years ± 11.97) initially included in this prospective study, 20 patients underwent surgery and were considered for further evaluation. 7 acquisitions of a 3D T 1-weighted FLASH sequence were performed following administration of gadofosveset for the assessment of the vascular anatomy and collecting system at predefined time points at 1.5 T. All MR exams were prospectively analyzed by 2 radiologists in consensus mode prior to surgery. In addition, ROI-based relative SNR measurements were performed in the vena cava inferior and abdominal aorta.
MR image acquisition was completed in all 20 potential living donors. In 8 donors an additional CT scan was available for further comparison with the collateral anatomy, resulting in a total of 28 analyzed kidneys. MRA disclosed 36 renal arteries, since 8 accessory arteries were found in 8 subjects. One accessory artery and one case of fibromuscular dysplasia were missed by MRA. The venous anatomy and the collecting system were assessed correctly with MRI. In addition, MRI diagnosed two renal cell carcinomas. The overall sensitivity and positive predictive value of gadofosveset-enhanced MRI on a per kidney basis were 92.9 % and 100 %, respectively.
Gadofosveset enables accurate evaluation of potential LKDs.
本研究旨在评估血池造影剂gadofosveset用于活体肾供体（LKD）肾血管系统的磁共振血管造影（MRA）。
本前瞻性研究最初纳入28例连续的潜在LKD（13例男性，15例女性；平均年龄55.14岁±11.97），其中20例患者接受了手术并被纳入进一步评估。在1.5T场强下，注射gadofosveset后按照预定时间点进行7次三维T1加权快速小角度激发（FLASH）序列采集，以评估血管解剖结构和集合系统。所有MR检查在手术前由2名放射科医生采用一致模式进行前瞻性分析。此外，在 inferior腔静脉和腹主动脉中进行基于感兴趣区（ROI）的相对信噪比测量。
所有20例潜在活体供体均完成了MR图像采集。8例供体有额外的CT扫描用于与侧支血管解剖结构进一步对比，共计28个肾脏接受分析。MRA共显示36支肾动脉，因为在8名受试者中发现了8支副肾动脉。MRA漏诊了1支副肾动脉和1例纤维肌发育异常。MRI正确评估了静脉解剖结构和集合系统。此外，MRI诊断出2例肾细胞癌。基于每个肾脏，gadofosveset增强MRI的总体敏感度和阳性预测值分别为92.9%和100%。
Gadofosveset能够准确评估潜在的LKD。
