Universität zu Köln

Gietzen, Carsten ORCID: 0000-0002-2354-3847, Tristram, Juliana ORCID: 0000-0003-0987-7987, Janssen, Jan Paul ORCID: 0000-0003-0980-4606, Hummels, Marielle ORCID: 0000-0001-7410-8581, Bremm, Johannes ORCID: 0000-0002-6081-1070, Kaya, Kenan ORCID: 0009-0008-7625-3457, Gietzen, Thorsten ORCID: 0000-0001-7948-202X, Pennig, Henry, Gertz, Roman ORCID: 0000-0002-6414-4105, Persigehl, Thorsten ORCID: 0000-0001-5928-4405, Stippel, Dirk ORCID: 0000-0002-1107-0907, Weiss, Kilian and Pennig, Lenhard ORCID: 0000-0002-6606-9313 (2025). Imaging of the renal allograft vasculature without gadolinium contrast: Intraindividual comparison between relaxation-enhanced angiography without contrast and triggering (REACT) and 4D contrast-enhanced MR-angiography. Magnetic Resonance Imaging, 122. pp. 1-10. Elsevier. ISSN 0730725X

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Abstract

[Artikel-Nr.: 110423] Background: Complications after kidney transplantation include transplant renal artery stenosis (TRAS), which can be assessed using Doppler ultrasonography, computed tomography angiography, and magnetic resonance angiography (MRA). Contrast-enhanced MRA (CE-MRA) has limitations, including potential allergic reactions, limited use in kidney failure, and uncertain long-term effects of gadolinium retention. Purpose: To evaluate Relaxation-Enhanced Angiography without Contrast and Triggering (REACT), a novel 3D isotropic flow-independent non-CE-MRA pulse sequence, for imaging of the renal allograft vasculature by performing an intraindividual comparison to 4D CE-MRA at 3Tesla. Methods: Forty studies of 39 patients were included in this retrospective, single-centre study. Two board-certified radiologists independently evaluated MRA datasets for TRAS and rated their diagnostic confidence and the image quality of pelvic vessels using 5-point Likert scales (5 = excellent). Apparent signal- and contrast-to-noise ratios (aSNR/aCNR) were measured for arterial and venous graft vessels. Results: REACT (median acquisition time 04:33 min [IQR 3:58–5:20 min]) showed 90.0 % sensitivity and 100.0 % specificity for TRAS in almost perfect agreement (r = 0.97) with 4D CE-MRA (03:41 min [3:38–4:46 min], p = 0.001) and similar diagnostic confidence (REACT: 4.0 [4.0–4.0] vs. 4D CE-MRA: 4.0 [3.0–4.0], p = 0.54). Arterial image quality was comparable (4.0 [3.7–4.4] vs. 4.0 [4.0–4.4], p = 0.49) whereas veins yielded higher scores in REACT (3.2 [3.0–3.5] vs. 2.4 [2.0–3.0], p < 0.001). Transplant renal artery (mean ± SD; 44.5 ± 18.2 vs. 45.9 ± 21.0, p = 0.71; 36.3 ± 15.0 vs. 41.0 ± 20.0, p = 0.16) and vein (37.1 ± 19.8 vs. 30.3 ± 15.2, p = 0.06; 29.4 ± 17.1 vs. 25.0 ± 14.7, p = 0.17) showed no difference in aSNR and aCNR. Conclusion: REACT provides accurate detection of TRAS with image quality comparable to 4D CE-MRA, offering a risk-free alternative for imaging after renal transplantation.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Gietzen, Carsten UNSPECIFIED https://orcid.org/0000-0002-2354-3847 UNSPECIFIED Tristram, Juliana UNSPECIFIED https://orcid.org/0000-0003-0987-7987 UNSPECIFIED Janssen, Jan Paul UNSPECIFIED https://orcid.org/0000-0003-0980-4606 UNSPECIFIED Hummels, Marielle UNSPECIFIED https://orcid.org/0000-0001-7410-8581 UNSPECIFIED Bremm, Johannes UNSPECIFIED https://orcid.org/0000-0002-6081-1070 UNSPECIFIED Kaya, Kenan UNSPECIFIED https://orcid.org/0009-0008-7625-3457 UNSPECIFIED Gietzen, Thorsten UNSPECIFIED https://orcid.org/0000-0001-7948-202X UNSPECIFIED Pennig, Henry UNSPECIFIED UNSPECIFIED UNSPECIFIED Gertz, Roman UNSPECIFIED https://orcid.org/0000-0002-6414-4105 UNSPECIFIED Persigehl, Thorsten UNSPECIFIED https://orcid.org/0000-0001-5928-4405 UNSPECIFIED Stippel, Dirk UNSPECIFIED https://orcid.org/0000-0002-1107-0907 UNSPECIFIED Weiss, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Pennig, Lenhard UNSPECIFIED https://orcid.org/0000-0002-6606-9313 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-805283
Identification Number:	10.1016/j.mri.2025.110423
Journal or Publication Title:	Magnetic Resonance Imaging
Volume:	122
Page Range:	pp. 1-10
Number of Pages:	10
Date:	October 2025
Publisher:	Elsevier
ISSN:	0730725X
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Chirurgie > Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Transplantationschirurgie Faculty of Medicine > Chirurgie > Klinik und Poliklinik für Herzchirurgie Faculty of Medicine > Radiologische Diagnostik > Institut und Poliklinik für Radiologische Diagnostik
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Renal allograft vasculature ; Transplant renal artery stenosis ; Pelvic arteries and veins ; Contrast-enhanced magnetic resonance ; angiography ; Relaxation-enhanced angiography without contrast and triggering English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80528