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To evaluate whether combined contrast enhanced MRA and MRI (ce-MRA-MRI) has the potential to replace intra-arterial DSA (i.a.DSA) in patients with impaired graft function or suspected of vascular complications after pancreas and/or kidney transplantation. 7 patients after combined pancreas-kidney and 22 patients after kidney transplantation underwent ce-MRA-MRI and i.a.DSA within a 3 days interval. Qualitative and quantitative comparison of the arterial and venous supply, the parenchyma and urinary collecting system was made. Both ce-MRA and i.a.DSA showed good results in the detection of arterial stenoses. However, ce-MRA falsely suggested stenoses if vascular clips were used; on the other hand, i.a.DSA was less informative if the graft arteries were very tortuous. Ce-MRA was superior in depicting the venous anatomy (p < 0.001) and the parenchymal enhancement of the pancreatic grafts. For the assessment of the contrast excretion, the pyelocalyceal system and the ureter of the renal graft ce-MRA-MRI was superior (p < 0.001), for small caliber arteries in the renal grafts i.a.DSA was of greater value (p < 0.001). The combination of ce-MRA and MRI is reliable for evaluating the vascular anatomy and has several advantages over i.a.DSA after pancreas and/or kidney transplantation. It can replace i.a.DSA in patients with impaired graft function or suspected of vascular complications after pancreas and/or kidney transplantation.

Type

Journal article

Journal

Magn Reson Imaging

Publication Date

06/2001

Volume

19

Pages

595 - 607

Keywords

Adult, Aged, Angiography, Digital Subtraction, Artifacts, Female, Graft Rejection, Humans, Image Enhancement, Ischemia, Kidney, Kidney Transplantation, Magnetic Resonance Angiography, Magnetic Resonance Imaging, Male, Middle Aged, Pancreas, Pancreas Transplantation, Postoperative Complications, Predictive Value of Tests