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  • 1
    Keywords: COMBINATION ; evaluation ; ALGORITHM ; VOLUME ; ACCURACY ; SURGERY ; TIME ; PATIENT ; DONOR ; intraoperative ; BODY-WEIGHT ; MR ; FIELD ; MAGNETIC-RESONANCE ; DISPLAY ; arteries ; MR-ANGIOGRAPHY ; magnetic resonance angiography ; ANOMALIES ; contrast-enhanced magnetic resonance angiography ; CT ANGIOGRAPHY ; DIGITAL SUBTRACTION ANGIOGRAPHY ; DIGITAL-SUBTRACTION-ANGIOGRAPHY ; gadobenate dimeglumine ; KIDNEY DONORS ; maximum intensity projection ; MAXIMUM-INTENSITY-PROJECTION ; pathology ; renal angiography ; shaded-surface display ; TRANSPLANT DONORS ; UROGRAPHY ; volume rendering
    Abstract: The aim of this study was to assess the value of contrast- enhanced three-dimensional MR angiography (CE 3D MRA) in the preoperative assessment of potential living renal donors, and to compare the accuracy for the depiction of the vascular anatomy using three different rendering algorithms. Twenty- three potential living renal donors were examined with CE 3D MRA (TE/TR=1.3 ms/3.7 ms, field of view 260-320x350 mm, 384- 448x512 matrix, slab thickness 9.4 cm, 72 partitions, section thickness 1.3 rum, scan time 24 s, 0.1 mmol/kg body weight gadobenate dimeglumine). Magnetic resonance angiography data sets were processed with maximum intensity projection (MIP), volume rendering (VR), and shaded-surface display (SSD) algorithms. The image analysis was performed independently by three MR-experienced radiologists recording the number of renal arteries, the presence of early branching or vascular pathology. The combination of digital subtraction angiography (DSA) and intraoperative findings served as the gold standard for the image analysis. In total, 52 renal arteries were correspondingly observed in 23 patients at DSA and surgery. Other findings were 3 cases of early branching of the renal arteries, 4 cases of arterial stenosis and I case of bilateral fibromuscular dysplasia. With MRA source data all 52 renal arteries were correctly identified by all readers, compared with 51 (98.1%), 51-52 (98.1-100%) and 49-50 renal arteries (94.2-96.2%) with the MIP, VR and SSD projections, respectively. Similarly, the sensitivity, specificity and accuracy was highest with the MRA source data followed by MIP, VR and SSD. Time requirements were lowest for the MIP reconstructions and highest for the VR reconstructions. Contrast-enhanced 3D MRA is a reliable, non-invasive tool for the preoperative evaluation of potential living renal donors. Maximum intensity projection is favourable for the processing of 3D MRA data, as it has minimal time and computational requirements, while having similar or superior accuracy for the depiction of vessel anomalies or pathology compared with VR and SSD, respectively
    Type of Publication: Journal article published
    PubMed ID: 12664119
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  • 2
    Keywords: Germany ; MODEL ; CT ; DIAGNOSIS ; computed tomography ; RESOLUTION ; kidney ; renal ; DIFFERENCE ; arteries ; tomography ; COMPUTED-TOMOGRAPHY ; DIGITAL SUBTRACTION ANGIOGRAPHY ; DIGITAL-SUBTRACTION-ANGIOGRAPHY ; maximum intensity projection ; MAXIMUM-INTENSITY-PROJECTION ; ARTERY ; VESSELS ; angiography,kidney,multislice computed tomography (MS-CT),resolution digital subtraction angiography ; HELICAL CT ANGIOGRAPHY
    Abstract: Objective: To compare maximum spatial resolution in multislice computed tomography (MS-CT) and digital subtraction angiography (DSA) using an arterial tree model for canine kidney specimens.Methods: Twenty-three isolated fox terrier kidneys were catheterized with a 4F catheter and underwent contrast-enhanced MS-CT with a maximum spatial resolution of 0.23-mm isotropic voxel size in an early arterial phase. In addition, a digital subtraction angiogram was performed on all kidneys. The kidneys were segmented semiautomatically, and each parenchymal vessel that was identified in the kidney was marked. The maximum intensity projections of arterial vessels in the CT datasets were evaluated in a comparison with the DSA datasets.Results: No significant difference in vessel delineation and count was found at any level up to the fourth level of intrarenal branching.Conclusion: MS-CT has the potential of replacing DSA in the diagnosis of intrarenal arteries
    Type of Publication: Journal article published
    PubMed ID: 14600451
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  • 3
    Keywords: tumor ; carcinoma ; CELL ; Germany ; CT ; imaging ; TUMORS ; computed tomography ; SURGERY ; renal ; INJECTION ; MRI ; SEQUENCE ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; DIFFERENCE ; tomography ; CARCINOMAS ; COMPUTED-TOMOGRAPHY ; ANGIOGRAPHY ; MASSES ; CELL CARCINOMA ; EXTENSION ; SURGICAL-TREATMENT ; CAVA TUMOR THROMBUS ; PREOPERATIVE EVALUATION ; renal cell carcinoma,staging,multidetector computed tomography,magnetic resonance imaging ; VENA-CAVA
    Abstract: Objective: The aim of this prospective study is to compare the diagnostic accuracy of multidetector-row computed tomography (CT) and magnetic resonance imaging (MRI) in tumor staging of renal cell carcinomas.Methods: in a prospective study, 82 renal cell carcinomas were assessed for tumor staging before surgery using multidetector-row CT and MRI, the results of which were then correlated to histopathologic staging. Triphasic CT (noncontrast, arterial phase, and parenchymal phase) imaging was performed using multi detector-row CT with a reconstructed slice thickness of 2 mm. In MRI, a transverse T1-weighted gradient echo sequence with and without administration of Gd-DTPA, a transverse T2-weighted respiratory-gated turbo spin echo (TSE) sequence, and a coronal T1-weighted gradient echo sequence with Gd-DTPA were used. In addition, multiphasic 3-dimensional angiography after Gd-DTPA injection and a transverse T1-weighted fat-suppression sequence were performed.Results: With MRI, readers 1 and 2 correctly staged 71 and 64 tumors (overall accuracy of 0.87 and 0.78, respectively) and achieved Mantel-Haenszel X-2 values of 66 and 63 (P 〈 0.0001). Computed tomography allowed correct staging of 68 and 66 tumors (readers 1 and 2, overall accuracy of 0.83 and 0.80, respectively) with Mantel-Haenszel X-2 values of 54 and 54 for CT staging (P 〈 0.0001). No statistically significant difference between overall accuracy was found in the X-2 test (P 〉 0. 15).Conclusion: Magnetic resonance imaging and multidetector-row CT with its multiplanar reconstruction capabilities achieve similar accuracy in tumor staging of renal cell carcinomas
    Type of Publication: Journal article published
    PubMed ID: 15100536
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  • 4
    Keywords: CANCER ; tumor ; carcinoma ; Germany ; CT ; imaging ; ACCURACY ; computed tomography ; PATIENT ; prognosis ; MR ; MRI ; SEQUENCE ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; US ; tomography ; CARCINOMAS ; COMPUTED-TOMOGRAPHY ; sensitivity ; volume rendering ; ANGIOGRAPHY ; GD-DTPA ; nuclear medicine ; RECONSTRUCTION ; MR imaging ; staging ; renal cell carcinoma ; EXTENSION ; SURGICAL-TREATMENT ; PROTOCOL ; 3D ; CELL-CARCINOMA ; RENAL-CELL-CARCINOMA ; surgical planning ; caval thrombus ; COMPUTERIZED-TOMOGRAPHY ; multidetector CT ; TSE ; TUMOR THROMBUS ; VEIN ; VENACAVOGRAPHY
    Abstract: Objective: To evaluate the accuracy of multidetector computed tomography (CT) and magnetic resonance imaging (MRI) in staging and estimating renal carcinomas with caval thrombus. Methods: Initially, 23 patients with suspected caval thrombi were admitted into this prospective study. Triphasic CT imaging was performed using a multidetector CT with a reconstructed slice thickness of 2 mm. 3D CT reconstructions were used to improve surgical planning. MRI protocol included: a transversal T1-weighted GE sequence with and without Gd-DTPA, a transversal T2-weighted respiratory-gated TSE, and a coronal T1-weighted GE sequence with Gd-DTPA and fat saturation. In addition, a multiphase 3D angiography was performed after Gd-DTPA injection. Patients were divided into 3 groups: caval thrombus below the insertion of the hepatic veins, within the intrahepatic vena cava, and intra-atrial extension. The results the tumor thrombus extension and staging results of 2 independent readers were correlated with surgical and histopathological staging. Results: Of the 23 patients admitted, CT and MR scans of 14/13 patients respectively were correlated with histopathological workup. CT thrombus detection sensitivity and specificity for both readers was 0.93 and 0.8 respectively. MRI sensitivity and specificity for both readers was 1.0/0.85 and 0.75. Readers I and II evaluated the uppermost extension of the cranial tumor thrombus by both CT and MRI. CT and MR accuracy was 78% and 72%, 88% and 76% respectively. Conclusion: In cases of a suspected tumor thrombus, MRI and multidetector CT imaging showed similar staging results. Consequently, these staging modalities can be used to assess the extension of the tumor thrombus
    Type of Publication: Journal article published
    PubMed ID: 15665685
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