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Three-dimensional rotational angiography of transplanted renal arteries: influence of an extended angle of rotation on beam-hardening artifacts
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology. (RAD)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology. RAD.
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2005 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 46, no 2, 170-176 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE:

To investigate whether three-dimensional rotational angiography (3D-RA) of the transplant renal artery performed with an extended angle of rotation can reduce beam-hardening artifacts in 3D reconstructed images without image quality being lost or side effects to the transplanted kidney being increased.

MATERIAL AND METHODS:

3D-RA with a C-arm rotation of 180 degrees was performed consecutively in 12 renal transplanted patients with suspicion of renal artery stenosis. A 1.7-mm balloon occlusion catheter was placed using the crossover technique and this was compared to a protocol with 160 degrees rotation and a traditional 1.4-mm catheter in 10 patients. The occurrence of beam-hardening artifacts was registered and the effects of the reduced contrast load on image quality and of arterial occlusion on renal function were assessed.

RESULTS:

The extended angle of rotation, from 160 degrees to 180 degrees, reduced the beam-hardening artifacts. Artifacts were observed in 4/11 patients (36%) in the study group and in all 10 (100%) of the controls. There was no statistical difference regarding image quality between the two protocols. Renal function was equally affected in both protocols.

CONCLUSION:

3D-RA with an extended C-arm rotation reduced the beam-hardening artifacts. Image quality was not reduced despite the reduced contrast medium load. The different protocols had no effect on patient outcome.

Place, publisher, year, edition, pages
2005. Vol. 46, no 2, 170-176 p.
Keyword [en]
Adult, Aged, Angiography/*methods, Artifacts, Balloon Dilatation, Contrast Media/administration & dosage, Female, Humans, Imaging; Three-Dimensional, Kidney Transplantation/radiography, Male, Middle Aged, Renal Artery/*radiography/*transplantation, Renal Artery Obstruction/*radiography, Reproducibility of Results, Research Support; Non-U.S. Gov't, Rotation
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-91942DOI: 10.1080/02841850510020851PubMedID: 15902892OAI: oai:DiVA.org:uu-91942DiVA: diva2:164835
Available from: 2004-05-05 Created: 2004-05-05 Last updated: 2013-05-16Bibliographically approved
In thesis
1. 3D Rotational Angiography of Transplanted Renal Arteries: A Clinical and Experimental Study
Open this publication in new window or tab >>3D Rotational Angiography of Transplanted Renal Arteries: A Clinical and Experimental Study
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Three-dimensional rotational angiography (3D-RA) is an established method within the field of interventional neuroradiology. The method has also a great potential in other areas with a complicated arterial anatomy. The purpose of this study was firstly to develop an investigative protocol for 3D-RA in renal transplanted patients with threatening allograft failure in diagnosing stenosis in the transplanted renal artery; secondly the protocol was evaluated and compared with a modified protocol including reduced contrast medium load. Furthermore, the advantages of the 3D reconstructions compared to the angiographic images were evaluated, likewise if an extended angle of rotation reduced the artifacts in the 3D reconstructions. The two protocols were compared with regard to image quality and acute nephrotoxicity. The accuracy of Doppler ultrasonography and the result of percutaneous transluminal angioplasty (PTA) were also assessed.

3D-RA was consecutively performed in 57 renal transplanted patients with suspicion of renal artery stenosis. A significant stenosis was found in 49% of the patients. The 3D reconstructions profiled 43% of the transplant renal artery stenoses better than the angiographic images. An extended angle of rotation reduced the artifacts. There was no statistical difference regarding image quality between the two protocols, and the renal function was equally affected in both protocols. Doppler ultrasonography sensitivity was 100%; specificity was 48% and positive predictive value 67%. PTA had a technical success rate of 92% and a clinical success rate of 75% after 3 months.

3D-RA is a helpful supplement in cases with complicated vascular anatomy, especially when PTA may be indicated. The 3D reconstructions profile the course of the artery more frequently than the angiographic images and support PTA. The 3D reconstructions are degraded of artifacts. Sampling artifacts can be diminished by increased C-arm rotation and increased number of projections. The distortions caused by beam hardening remain to be solved.

Place, publisher, year, edition, pages
Uppsala: Institutionen för onkologi, radiologi och klinisk immunologi, 2004. 46 p.
Keyword
Radiology, Kidney, transplantation, renal angiography, renal arteries, stenosis or obstruction, imaging, three-dimensional, artifacts, Radiologisk forskning
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-4319 (URN)91-506-1748-6 (ISBN)
Public defence
2004-05-26, Enghoffsalen, Akademiska sjukhuset, Ing. 50, b.v., Uppsala, 09:15
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Available from: 2004-05-05 Created: 2004-05-05Bibliographically approved

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Wadström, JonasMagnusson, Anders

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