Preoperative evaluation of renal artery in patients with renal tumor: Using noncontrast-enhanced magnetic resonance angiography

Abstract

To investigate the feasibility of the noncontrast-enhanced magnetic resonance angiography (NCE-MRA) to evaluate renal arteries before partial nephrectomy (PN). Retrospective analyzed 479 patients who underwent renal surgery between January 2013 and December 2015 with NCE-MRA or computed tomographic angiography (CTA) renal artery image reconstruction preoperative in our department. The renal artery reconstruction score (RARS) was based on the level of artery visualization in a 4-class criterion, and the R.E.N.A.L nephrometry score (R.E.N.A.L), arterial based complexity (ABC) were also analyzed. Of the 479 patients, the overall-lever RARS was 3.62, and the average in 2 groups was no significant difference (NCE-MRA vs CTA, P=0.072). The performance of NCE-MRA in PN group was similar with CTA. Further comparison demonstrated that the efficiency of NCE-MRAinmoderate- or low-degree tumor according to the R.E.N.A.L and ABCcomplexity less than 3Swas equal to CTA. However, high degree (P<0.001), 3S (P=0.027), or3H(P<0.001)would affect the imaging of renal artery. Intragroup analysis showed that tumor complexity such as max tumor size (r=-o.351, P<0.001), R.E.N.A.L (r=-0.439, P<0.001), and ABC (r=-0.619, P<0.001) were closely correlated with the NCE-MRA performance. The images of 2 sides of the kidney were compared in single person as well, which was meaningful for NCE-MRA patients only (NCE-MRA, P<0.001; CTA, P=0.182). The renal artery reconstruction performed by NCE-MRA is feasible and has a similar achievement in the PN potential recipients, with a lower side effect, and meets the requirements for making surgical decision. It has a broad application prospect in clinical practice; however, it still needs to further improve the ability in more complex tumors.