New frontiers in MR angiography

"nTen years ago, as much as 80 mL Gadolinium (Gd) chelate was reported to be injected for MR angiography (MRA) in various publications. A drastic reduction of Gd chelate volumes has been observed in further publications, owing to new MR angiographic techniques, such as TRICKS where the amount of contrast does not exceed 0.5 mmol/kg body weight. Consecutively to the publication of several cases of nephrogenic systemic fibrosis, a drammatic consequence of Gd chelate injection, manufacturers have developed noncontrast MRA sequences. These sequences have several eponyms belonging to each manufacturer. The advantages of these sequences are the total avoidance of contrast medium injection. The drawbacks are the limited field-of-view and the absence of functional information upon parenchymal perfusion. Nevertheless, the large diagnostic perspectives of these sequences in patients with severe renal kidney diseases deserve major attention.