3D FIESTA pulse sequence for assessing renal artery stenosis: is it a reliable application in unenhanced magnetic resonance angiography?

Results: A total of 186 renal arteries were assessed; 36 had RAS ≥ 50 % demonstrated by CE-MRA. Ten patients underwent DSA, for a total evaluation of 22 arteries. Sensitivity, specificity, NPV, PPV, and accuracy of 3D FIESTA were 91.7 %, 100 %, 98 %, 100 %, and 98 %, respectively, as compared to CE-MRA, and 88.2 %, 100 %, 71.4 %, 100 %, and 91 %, respectively, as compared to DSA. The area under the ROC curve (AUC) of 3D FIESTA as compared to CE-MRA and DSA was 0.958 and 0.941, respectively.Conclusions: Our study demonstrated the capability of the 3D FIESTA sequence in evaluating RAS, with high-quality images and good diagnostic accuracy.Key Points: • The 3D FIESTA sequence provides a robust evaluation of RAS.• The 3D FIESTA sequence allows non-invasive evaluation of the renal arteries.• The 3D FIESTA sequence could be a useful tool in evaluating RAS.Methods: We retrospectively analysed 79 patients referred for suspected RAS, examined by 3D FIESTA and contrast-enhanced magnetic resonance angiography (CE-MRA), using a 1.5T whole-body scanner. Image quality was assessed as well as the presence and grade of RAS. Patients with RAS ≥ 50 % were evaluated for possible digital subtraction angiography (DSA). Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of 3D FIESTA were calculated with ROC analysis using CE-MRA and DSA as the standard of reference.Objectives: To assess the capability of the three-dimensional (3D) Fast Imaging Employing Steady-State Acquisition (FIESTA) sequence in evaluating renal artery stenosis (RAS).