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Diagnostic Performance of Magnetic Resonance Angiography for Artery Stenosis After Kidney Transplant: A Systematic Review and Meta-Analysis

  • Author Footnotes
    # Yao Huang and Bin Zhang have contributed equally to the work.
    Yao Huang
    Footnotes
    # Yao Huang and Bin Zhang have contributed equally to the work.
    Affiliations
    Department of Radiology, The First Affiliated Hospital of Jinan University, No. 613 Huangpu West Road Tianhe District, Guangzhou, Guangdong, 510627 China (Y.H., B.Z., J.Z., X.M., S.Z., Q.C.)
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  • Author Footnotes
    # Yao Huang and Bin Zhang have contributed equally to the work.
    Bin Zhang
    Footnotes
    # Yao Huang and Bin Zhang have contributed equally to the work.
    Affiliations
    Department of Radiology, The First Affiliated Hospital of Jinan University, No. 613 Huangpu West Road Tianhe District, Guangzhou, Guangdong, 510627 China (Y.H., B.Z., J.Z., X.M., S.Z., Q.C.)
    Search for articles by this author
  • Jieling Zheng
    Affiliations
    Department of Radiology, The First Affiliated Hospital of Jinan University, No. 613 Huangpu West Road Tianhe District, Guangzhou, Guangdong, 510627 China (Y.H., B.Z., J.Z., X.M., S.Z., Q.C.)
    Search for articles by this author
  • Xiao Ma
    Affiliations
    Department of Radiology, The First Affiliated Hospital of Jinan University, No. 613 Huangpu West Road Tianhe District, Guangzhou, Guangdong, 510627 China (Y.H., B.Z., J.Z., X.M., S.Z., Q.C.)
    Search for articles by this author
  • Shuixing Zhang
    Affiliations
    Department of Radiology, The First Affiliated Hospital of Jinan University, No. 613 Huangpu West Road Tianhe District, Guangzhou, Guangdong, 510627 China (Y.H., B.Z., J.Z., X.M., S.Z., Q.C.)
    Search for articles by this author
  • Qiuying Chen
    Correspondence
    Address correspondence to: Q.C.
    Affiliations
    Department of Radiology, The First Affiliated Hospital of Jinan University, No. 613 Huangpu West Road Tianhe District, Guangzhou, Guangdong, 510627 China (Y.H., B.Z., J.Z., X.M., S.Z., Q.C.)
    Search for articles by this author
  • Author Footnotes
    # Yao Huang and Bin Zhang have contributed equally to the work.
Published:April 17, 2023DOI:https://doi.org/10.1016/j.acra.2023.02.034

      Rationale and Objectives

      Magnetic resonance angiography (MRA) is used to diagnose artery stenosis after kidney transplant. However, there is a lack of applicable consensus guidelines, and the diagnostic value of this technique is unclear. Therefore, the aim of the present study was to evaluate the diagnostic performance of MRA for the detection of artery stenosis after kidney transplant.

      Materials and Methods

      We searched PubMed, Web of Science, Cochrane Library, and Embase from database inception to September 1, 2022. Two independent reviewers assessed the methodological quality of eligible studies using the quality assessment of diagnostic accuracy studies-2 tool. The diagnostic odds ratio, pooled sensitivity, and specificity values, positive likelihood ratios, and negative likelihood ratios were calculated to synthesize data with a bivariate random-effects model. Meta-regression analysis was performed in cases of high among-study heterogeneity.

      Results

      Eleven studies were included in the meta-analysis. The area under the summary receiver operating characteristic curve was 0.96 (95% confidence interval [CI]: 0.94–0.98). The pooled sensitivity and specificity values for MRA in diagnosing artery stenosis after kidney transplant were 0.96 (95% CI: 0.76–0.99) and 0.93 (95% CI: 0.86–0.96), respectively.

      Conclusion

      MRA demonstrated high sensitivity and specificity for diagnosing artery stenosis after kidney transplant, suggesting that it may be used reliably in clinical practice. However, further large-scale studies are required to validate the present findings.

      Key Words

      Abbreviations:

      MRA (Magnetic resonance angiography), CE-MRA (Contrast-enhanced MRA), NCE-MRA (Non-contrast-enhanced MRA), TRAS (Transplant renal artery stenosis), TP (True positive), FP (False positive), TN (True negative), FN (False negative), SROC (Summary receiver operating characteristic), DSA (Digital subtraction angiography), PRISMA-DTA (The Preferred Reporting Items for Systematic Reviews and Meta- Analysis Statement of Diagnostic Test Accuracy), QUADAS-2 (Quality assessment was based on Quality Assessment of Diagnostic Accuracy Studies 2), TOF (Time of flight), Gd (Gadolinium), CTA (Computed tomography angiography)
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