Can contrast-enhanced renal MR angiography replace conventional angiography in preoperative evaluation of living renal donors?

The aim of the study was to detect if gadolinium-enhanced renal magnetic resonance angiography (MRA) can replace conventional angiography in imaging vascular anatomy in potential living renal donors and compare with surgical findings. MR imaging (MRI) and breath-hold three-dimensional gadolinium-enhanced MRA of kidneys were done for 60 consecutive patients for whom successful nephrectomy was done. MRA findings were compared with the findings of nephrectomy. MRI and MRA identified 28 out of 60 patients with normal arterial and venous anatomy,and concordance was found at surgery in 27 of these patients. Vascular anomalies were depicted on MRI in 32 patients,with concordance at surgery in 27 patients. Regarding arterial anomalies,the MRA had a sensitivity of 89.3%,a specificity of 94.0% and an accuracy of 90.8%. For venous anomalies,the sensitivity was 98.5%,specificity was 100% and accuracy was 98.6%. In conclusion,gadolinium-enhanced MRA of the kidneys can replace conventional angiography as a safe and accurate modality for the assessment of potential living renal donors.