MR renography with low-dose gadopentetate dimeglumine

Feasibility

V. S. Lee, H. Rusinek, G. Johnson, N. M. Rofsky, G. A. Krinsky, J. C. Weinreb

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

PURPOSE: To develop a low-dose magnetic resonance (MR) renographic method performed with and without an angiotensin converting enzyme (ACE) inhibitor and in conjunction with gadolinium-enhanced MR angiography in patients with suspected renovascular disease. MATERIALS AND METHODS: Thirty-two patients underwent MR renography (turbo fast low-angle shot sequence: repetition time, 5 msec; echo time, 2.3 msec; flip angle, 15°; one coronal image acquired every 2 seconds for 4 minutes) following intravenous injection of 2 mL of gadopentetate dimeglumine, which was repeated following intravenous injection of an ACE inhibitor. Contrast material-enhanced MR angiography was also performed. On the basis of renographic findings, renal cortex and renal medulla enhancement curves and normalized enhancement ratios were analyzed. RESULTS: The cortex and medulla showed an early transient period of enhancement within 20 seconds (vascular phase). During 1-2 minutes, a second, gradual increase in medullary enhancement, reflecting transit of filtered contrast material, was observed that was significantly greater in patients with a serum creatinine level less than 2 mg/dL (1 77 μmol/L) than in those with a level of 2 mg/dL or greater (P < .01). After injection of the ACE inhibitor, patients with elevated creatinine levels showed low renal medullary enhancement regardless of the presence of renal artery stenosis (RAS). However, in patients with creatinine less than 2 mg/dL, medullary enhancement ratios after injection of the ACE inhibitor were consistently lower in patients with RAS of 50% or greater than in those without stenosis (P = .02 to .08). CONCLUSION: Low-dose MR renography can be performed in the clinical setting before and after injection of an ACE inhibitor, and its potential use for evaluating decreased renal function as a consequence of RAS is promising.

Original languageEnglish (US)
Pages (from-to)371-379
Number of pages9
JournalRadiology
Volume221
Issue number2
StatePublished - 2001

Fingerprint

Radioisotope Renography
Gadolinium DTPA
Angiotensin-Converting Enzyme Inhibitors
Magnetic Resonance Spectroscopy
Renal Artery Obstruction
Kidney
Creatinine
Magnetic Resonance Angiography
Intravenous Injections
Contrast Media
Injections
Gadolinium
Blood Vessels
Pathologic Constriction
Serum

Keywords

  • Kidney, function
  • Magnetic resonance (MR), vascular studies
  • Renal arteries, stenosis or obstruction

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Lee, V. S., Rusinek, H., Johnson, G., Rofsky, N. M., Krinsky, G. A., & Weinreb, J. C. (2001). MR renography with low-dose gadopentetate dimeglumine: Feasibility. Radiology, 221(2), 371-379.

MR renography with low-dose gadopentetate dimeglumine : Feasibility. / Lee, V. S.; Rusinek, H.; Johnson, G.; Rofsky, N. M.; Krinsky, G. A.; Weinreb, J. C.

In: Radiology, Vol. 221, No. 2, 2001, p. 371-379.

Research output: Contribution to journalArticle

Lee, VS, Rusinek, H, Johnson, G, Rofsky, NM, Krinsky, GA & Weinreb, JC 2001, 'MR renography with low-dose gadopentetate dimeglumine: Feasibility', Radiology, vol. 221, no. 2, pp. 371-379.
Lee VS, Rusinek H, Johnson G, Rofsky NM, Krinsky GA, Weinreb JC. MR renography with low-dose gadopentetate dimeglumine: Feasibility. Radiology. 2001;221(2):371-379.
Lee, V. S. ; Rusinek, H. ; Johnson, G. ; Rofsky, N. M. ; Krinsky, G. A. ; Weinreb, J. C. / MR renography with low-dose gadopentetate dimeglumine : Feasibility. In: Radiology. 2001 ; Vol. 221, No. 2. pp. 371-379.
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AU - Krinsky, G. A.

AU - Weinreb, J. C.

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N2 - PURPOSE: To develop a low-dose magnetic resonance (MR) renographic method performed with and without an angiotensin converting enzyme (ACE) inhibitor and in conjunction with gadolinium-enhanced MR angiography in patients with suspected renovascular disease. MATERIALS AND METHODS: Thirty-two patients underwent MR renography (turbo fast low-angle shot sequence: repetition time, 5 msec; echo time, 2.3 msec; flip angle, 15°; one coronal image acquired every 2 seconds for 4 minutes) following intravenous injection of 2 mL of gadopentetate dimeglumine, which was repeated following intravenous injection of an ACE inhibitor. Contrast material-enhanced MR angiography was also performed. On the basis of renographic findings, renal cortex and renal medulla enhancement curves and normalized enhancement ratios were analyzed. RESULTS: The cortex and medulla showed an early transient period of enhancement within 20 seconds (vascular phase). During 1-2 minutes, a second, gradual increase in medullary enhancement, reflecting transit of filtered contrast material, was observed that was significantly greater in patients with a serum creatinine level less than 2 mg/dL (1 77 μmol/L) than in those with a level of 2 mg/dL or greater (P < .01). After injection of the ACE inhibitor, patients with elevated creatinine levels showed low renal medullary enhancement regardless of the presence of renal artery stenosis (RAS). However, in patients with creatinine less than 2 mg/dL, medullary enhancement ratios after injection of the ACE inhibitor were consistently lower in patients with RAS of 50% or greater than in those without stenosis (P = .02 to .08). CONCLUSION: Low-dose MR renography can be performed in the clinical setting before and after injection of an ACE inhibitor, and its potential use for evaluating decreased renal function as a consequence of RAS is promising.

AB - PURPOSE: To develop a low-dose magnetic resonance (MR) renographic method performed with and without an angiotensin converting enzyme (ACE) inhibitor and in conjunction with gadolinium-enhanced MR angiography in patients with suspected renovascular disease. MATERIALS AND METHODS: Thirty-two patients underwent MR renography (turbo fast low-angle shot sequence: repetition time, 5 msec; echo time, 2.3 msec; flip angle, 15°; one coronal image acquired every 2 seconds for 4 minutes) following intravenous injection of 2 mL of gadopentetate dimeglumine, which was repeated following intravenous injection of an ACE inhibitor. Contrast material-enhanced MR angiography was also performed. On the basis of renographic findings, renal cortex and renal medulla enhancement curves and normalized enhancement ratios were analyzed. RESULTS: The cortex and medulla showed an early transient period of enhancement within 20 seconds (vascular phase). During 1-2 minutes, a second, gradual increase in medullary enhancement, reflecting transit of filtered contrast material, was observed that was significantly greater in patients with a serum creatinine level less than 2 mg/dL (1 77 μmol/L) than in those with a level of 2 mg/dL or greater (P < .01). After injection of the ACE inhibitor, patients with elevated creatinine levels showed low renal medullary enhancement regardless of the presence of renal artery stenosis (RAS). However, in patients with creatinine less than 2 mg/dL, medullary enhancement ratios after injection of the ACE inhibitor were consistently lower in patients with RAS of 50% or greater than in those without stenosis (P = .02 to .08). CONCLUSION: Low-dose MR renography can be performed in the clinical setting before and after injection of an ACE inhibitor, and its potential use for evaluating decreased renal function as a consequence of RAS is promising.

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