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(Radiographics. 1999;19:1555-1568.)
© RSNA, 1999

SCIENTIFIC EXHIBIT

MR Angiography after Renal Revascularization: Spectrum of Expected Anatomic Results and Postintervention Complications1

Ruth C. Carlos, MD, Qian Dong, MD, James C. Stanley, MD and Martin R. Prince, MD, PhD

1 From the Departments of Radiology (R.C.C., Q.D., M.R.P.) and Surgery (J.C.S.), University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0030. Presented as a scientific exhibit at the 1998 RSNA scientific assembly. Received March 12, 1999; revision requested April 13 and received June 15; accepted June 21. Supported in part by the Robert Wood Johnson Clinical Scholars Program and the Whitaker Foundation. Address reprint requests to R.C.C.

The use of magnetic resonance (MR) angiography in screening for renal artery stenosis has been extensively evaluated. However, the MR angiographic findings after renal artery revascularization are not as well characterized. The renal artery and parenchyma can be evaluated after revascularization with a comprehensive MR imaging protocol that includes T1- and T2-weighted spin-echo sequences, three-dimensional (3D) gadolinium-enhanced MR angiography, and 3D phase-contrast MR angiography. Because surgical techniques for revascularization vary, knowledge of the surgical procedure is necessary to ensure inclusion of the pertinent anatomy at 3D gadolinium-enhanced MR angiography and to define appropriate 3D phase-contrast MR angiography volumes. The 3D gadolinium-enhanced MR angiography volume can be manipulated to view relevant vascular anatomy at the optimal obliquity and section thickness. This protocol allows robust, noninvasive evaluation of the expected arterial anatomy after revascularization, including renal artery endarterectomy, aortorenal bypass grafts, and extraanatomic reconstructions. In cases of suspected postrevascularization complications, gadolinium-enhanced MR angiography is useful because of its lack of nephrotoxicity and radiation exposure. Immediate complications of renal revascularization include renal artery thrombosis, renal infarction, and perinephric hemorrhage. Long-term complications include aneurysms of bypass grafts and recurrent stenosis of the renal artery.

Index Terms: Arteries, surgery, 961.45 • Gadolinium • Magnetic resonance (MR), vascular studies, 961.129415, 961.12942 • Renal arteries, MR, 961.129415, 961.12942 • Renal arteries, stenosis or obstruction, 961.72






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