Renal MR angiography: A comprehensive approach

Renal artery MR angiography has now emerged as a safe, accurate approach to renal arteriography. A comprehensive examination, including both three‐dimensional (3D) dynamic gadolinium‐enhanced and 3D phase contrast MRA techniques, allows evaluation of both the aorta‐renal and splanchnic arterial anatomy as well as the hemodynamic significance of any stenoses identified. The 3D gadolinium‐enhanced MRA technique produces a contrast arteriogram but without risks of iodinated contrast or ionizing radiation. The 3D phase contrast technique is a flow‐based technique, which may show dephasing in the presence of hemodynamically significant stenoses. A comprehensive examination should also include T1‐ and T2‐weighted imaging for the assessment of potential neoplastic masses and the ubiquitous renal cysts. Through trial and error over the course of over a thousand examinations, this comprehensive approach to the MR evaluation of renal vascular pathology has emerged.