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MR Angiography of Renal Vascular Malformations

Objective We wanted to determine whether three-dimensional phase contrast (3DPC) MR angiography is clinically useful in the diagnosis of renal vascular malformations. Materials and Methods Three-dimensional PC MR angiography was performed in 22 patients with gross hematuria and in 8 healthy volunteers. Small flip angles and 60 cm/s velocity encoding best demonstrated the normal intra-renal arteries with arteriovenous differentiation in the eight healthy volunteers. In the 22 patients with gross hematuria, intraarterial digital subtraction angiography demonstrated cirsoid-type malformations in 6 patients, aneurysmaltype malformations in 3 patients, and normal vascular anatomy in 13 patients. Results Magnetic resonance angiography detected all three aneurysmaltype malformations and four of the cirsoid-type malformations. Small cirsoid-type malformations were not detected in two patients. The moderate or large malformations were demonstrated as dilated and tortuous feeding arteries and high intensity renal veins with high flow velocity. We found no correlation between signal intensity in the suprarenal inferior vena cava and the presence of arteriovenous shunts. There were no false-positive cases. Conclusion Sensitivity, specificity, and accuracy in this series were 78, 100, and 91%, respectively.