Objective: to evaluate the potentials of contrast-free renal arterial spin labeling (ASL) perfusion during magnetic resonance imaging (MRI) for the diagnosis and dynamic follow-up of renal lesions in patients with diffuse liver diseases (DLD). Material and methods. The prospective study enrolled 82 patients with various DLD: alcoholic, viral, druginduced, autoimmune and mixed etiology. Ultrasound examination with Doppler abdominal and renal ultrasonography was conducted using Apogee 5300 (SIUI, China); abdominal MRI with contrast-free renal ASL-perfusion was performed using Vantage Titan 1.5 T (Toshiba, Japan). The parameters of renal perfusion (renal blood flow, RBF) were measured when the patients were admitted to the hospital, then during dynamic follow-up for 18 months. Results. Mathematical processing of results revealed normal RBF values (≥ 450 ml/100 g/min) and values associated with hepatorenal syndrome (HRS) (≤ 449 ml/100 g/min). High correlation between renal ASL-perfusion indicators and results of Doppler renal vessels ultrasonography was detected (r = 0,856). The diagnostic effectiveness parameters of contrast-free renal ASL-perfusion were: sensitivity 0.83, specificity 0.92, diagnostic accuracy 0.87. We created the algorithm of DLD patients examination for early HRS diagnosis and follow-up. Conclusion. Contrast-free renal ASL-perfusion is an informative method for predicting, diagnosis and dynamic follow-up of renal lesions in patients with various DLD.
The aim of this work is to evaluate possibilities of MR liver non-contrast perfusion in patients with diffuse liver diseases (DLD). Laboratory data, results of ultrasound examination with doppler ultrasonography of liver vessels, results of MRI with non-contrast MR perfusion (ASL-perfusion) of the liver was estimated in a group of patients with DLD. Potentials of assessment of ASL liver perfusion for clinical form prediction are described in the article. Potentials of using the assessment of ASL liver perfusion for information about a liver blood flow type and process activity indicators by blood chemistry are also described. It was established, that ASL MR of the liver is recommended to use in patients with diffuse liver diseases who admitted to a hospital, then in 1 month (in case of hypo/hyperperfusion) or in 6 months (in case of normal perfusion).
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