Noninvasive angiography in preoperativeevaluation of complicated pediatric renal masses using phase contrast magnetic resonance angiography

Objectives: To report a new technique called "phase contrast magnetic resonanceangiography" (PC MRA) utilizing phase contrast magnetic resonance imaging, for assessing the renal vasculature in relation to complicated pediatric renal masses. Methods: Three-dimensional phase contrast gradient refocused pulse sequences wereobtained on four pediatric patients with complicated renal masses. Findings were compared to ultrasound and computed tomographic images and correlated with actual surgical anatomy. Results: In all four cases PC MRA provided standard angiographic quality detail of the renal vascular anatomy. The PC MRA findings had a 100% correlation with surgical exploration and MRA proved to be approximately one third the cost of the standard angiographic technique. Conclusions: Our experience with the use of PC MRA in children suggests that it canbe helpful in evaluating the vasculature of complicated pediatric renal masses. PC MRA utilizes current generation magnetic resonance units, is noninvasive, and does not require anesthesia. It may be especially useful in patients with hypersensitivity to contrast agents, in those with renal failure in whom contrast agents may be contraindicated, and is less expensive than standard angiography.