Radiologists should look beyond renal arteries in renal MRAs

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Radiologists need to look beyond the renal arteries when doing renal MR angiography (MRA), according to a study published in the September issue of the American Journal of Roentgenology. In fact, 98 percent of patients who underwent renal MRA had one or more additional vascular or nonvascular findings.

The study consisted of 380 patients who underwent an MRA exam, and of those patients, 151 (40 percent) had one or more additional vascular findings not related to renal arteries.

The findings included mesenteric artery stenosis or occlusion in 33 percent of patients, moderate to severe aortic atherosclerosis in 17 percent and aortic aneurysms in 7 percent, according to James Glockner, MD, lead author of the study.

Also, of the 380 patients, 221 (58 percent) had one or more nonvascular findings, most of those being benign lesions, but malignancies were detected in 10 patients.

The study’s main implication “is that incidental findings are common enough that we need to look for them, and that our MRA protocols should include at least a few additional sequences so that most of the incidental findings can be interpreted unambiguously without the need for another exam,” Glockner said.

The study was conducted at the Mayo Clinic in Rochester, Minn.