Non-Contrast Enhanced Renal Angiography Using Multiple Inversion Recovery and Steady-State Free Precession

Introduction: Renal artery stenosis (RAS) is a well-known cause of renal hypertension and can lead to chronic kidney failure. The recent connection between gadolinium contrast agents and nephrogenic systemic fibrosis (NSF) has prompted renewed interest in non-contrast enhanced MR angiography (NCE MRA) for the diagnosis of RAS, most notably methods based on 3D balanced steady-state free precession (SSFP) [1-3]. The use of an inversion preparatory pulse with SSFP has been proposed to suppress signals from kidney parenchyma and static blood, thereby allowing higher contrast of the renal arteries [1, 2]. Stronger background tissue suppression, including fat, may be achieved by using multiple inversions to concurrently suppress a broad range of T1's [4, 5]. Previous work showed that this nulling technique offers high contrast in 2D projective renal angiography [5]. In this work, we investigate the use of multiple inversion recovery suppression with 3D balanced SSFP (MIR SSFP) to provide high contrast in renal NCE MRA. Results are compared with balanced SSFP without any magnetization preparation or triggering (plain SSFP), and slab-selective single inversion SSFP (Inv SSFP) [2].