TITLE EFFICACY OF UNENHANCED MAGNETIC RESONANCE RENAL ANGIOGRAPHY IN PATIENTS WITH ACUTE /CHRONIC KIDNEY DISEASE WITH CLINICAL SUSPICION OF RENOVASCULAR.

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TITLE EFFICACY OF UNENHANCED MAGNETIC RESONANCE RENAL ANGIOGRAPHY IN PATIENTS WITH ACUTE /CHRONIC KIDNEY DISEASE WITH CLINICAL SUSPICION OF RENOVASCULAR HYPERTENSION

AUTHOR’S LIST AND INSTITUITION Presenting Author : YAMUNA.J Co-Authors : Anupama Chandrasekharan, Rajeswaran.R, S.Ramalakshmi,Santhosh Joseph Name of instituition :Sri Ramachandra Medical College,Porur,Chennai,India. PIN

AIM To study the efficacy of unenhanced magnetic resonance renal angiography in acute /chronic kidney disease patients with suspected renovascular hypertension

MATERIALS AND METHODS Sixteen patients with chronic kidney disease and three patients with acute kidney disease,with clinical suspicion of renovascular hypertension were subjected to unenhanced magnetic resonance angiography of renal arteries, using free breathing ECG gated unenhanced true FISP technique.Images were obtained from Siemens Magnetom Avanto 1.5 T MRI Scanner and findings were correlated with clinical and catheter angiography findings. More than 70% stenosis on MRA or nonresponse to medical treatment were indications for catheter angiography in our study.

RESULTS 39 renal arteries of 19 patients were evaluated by MRA. 5 renal arteries (5 patients) showed more than 70% stenosis. Severity of stenosis on unenhanced MRA correlated with catheter angiography in 4 renal arteries.In 1 renal artery, there was overestimation of stenosis on MRA due to previously placed stent. Less than 70% stenosis or normalcy was seen in 34 renal arteries and correlated with clinical follow up. They responded to conservative management with control of blood pressure, non deterioration of renal and pulmonary function. Unenhanced MRA had an accuracy of 97 % in present study

CONCLUSION Unenhanced magnetic resonance angiography is a useful tool in assessment of renal arteries in patients with kidney disease and suspected renovascular hypertension, in whom intravenous contrast is relatively contraindicated.Unenhanced MR renal angiography is of immense benefit in categorising such patients into those who can be managed conservatively and those who require catheter angiography for further management.