MR Imaging of Living Kidney Donors

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 0.50
Procedures: 0.50
Abdomen and Pelvis: 0.50

Magnetic Resonance Imaging: 1.25
Image Production: 0.50
Sequence Parameters and Options: 0.25
Data Acquisition, Processing, and Storage: 0.25
Procedures: 0.75
Body: 0.75

Nuclear Medicine Technology: 0.50
Procedures: 0.50
Gastrointestinal and Genitourinary Procedures: 0.50

Radiography: 0.50
Procedures: 0.50
Thorax and Abdomen Procedures: 0.50

Registered Radiologist Assistant: 1.00
Procedures: 1.00
Abdominal Section: 1.00

Sonography: 0.50
Procedures: 0.50
Abdomen: 0.50

Radiation Therapy: 1.00
Patient Care: 0.50
Patient and Medical Record Management: 0.50
Procedures: 0.50
Treatment Sites and Tumors: 0.50

Vascular-Interventional Radiography: 0.50
Procedures: 0.50
Vascular Diagnostic Procedures: 0.50

Vascular Sonography: 0.50
Procedures: 0.50
Abdominal/Pelvic Vasculature: 0.50

Outline

1. Introduction
2. MR Imaging Technique
3. Postprocessing of 3D Data Sets
4. MR Imaging Findings versus Those of Other Imaging Modalities
5. Discussion and Conclusions

Objectives

Upon completion of this course, students will:

1. know the rate at which end-stage renal disease is increasing
2. list the benefits of living donor transplantation
3. list the benefits of laparoscopic nephrectomy
4. understand the conditions which may require an open nephrectomy
5. know which renal exams can and cannot be replaced by MRI
6. understand what a preoperative MRI exam should evaluate
7. know in which planes T2-weighted FSE or SSFSE images should be acquired
8. understand the benefits of coronal T2 imaging
9. know the best plane to demonstrate the relationship of the kidneys to the liver and spleen
10. understand how to use axial T2 imaging
11. understand what technical factors should be minimized to limit background signal in a renal MR arteriogram
12. be familiar with the use of coronal fast GRE in a comprehensive renal donor protocol
13. understand why post contrast axial fast GRE is done
14. know the parameters used to calculate the imaging delay
15. be familiar with parameter selection when planning Coronal fast GRE venogram
16. understand why to modify the coronal fast GRE for venous anatomy vs arterial anatomy
17. understand which imaging matrix is preferred
18. know the placement of the coronal fast GRE relative to the vascular anatomy
19. understand the post processing of 3D CEMRA of the renal arteries/veins
20. understand the use of targeted MIP
21. be familiar with the effect of anisotropy, pulsation, and peristalsis on reformatted images
22. know which types of reformatted images are not commonly used to evaluate renal vasculature
23. be familiar with vascular anomalies found in renal donor candidates
24. know the prevalence of multiple renal arteries
25. know what percentage of kidneys have two or more arteries
26. know what flip angles are used in abdominal MRA (arterial) sequences
27. understand the prevalence of multiple renal arteries compared to that of multiple renal veins
28. know what the most common variant of the left renal vein is
29. be familiar with renal vasculature
30. be familiar with renal vascular anomalies
31. be familiar with renal parenchymal abnormalities in living donors
32. understand why MRI is preferable for healthy donor work-up
33. know the best MRA technique for renal veins
34. understand the conditions for which MRI is effective
35. know the accuracy of MR and CT in the evaluation of the main renal arteries and larger accessory arteries.