Evaluating Renal Fibrosis with R2* Histogram Analysis of the Whole Cortex in a Unilateral Ureteral Obstruction Model

Zha, Tingting; Ren, Xiaojun; Zhou, Xing; Zhang, Jinggang; Tian, Xiaojuan; Du, Yanan; Xing, Wei; Chen, Jie

doi:10.1016/j.acra.2018.07.010

Cited by 14 publications

(12 citation statements)

References 32 publications

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“…The utility of BOLD-MRI has been investigated in a number of studies. For example, in a rabbit model of UUO, Woo et al 40 and Zha et al 115 found that T 2 * correlated well with the percentage of renal fibrosis in the kidney. In folic acid-induced murine AKI, Jiang et al observed a good correlation between R 2 * and renal fibrosis in the renal cortex, but not in the medulla.…”

Section: Blood Oxygenation Level Dependent Mri Principlesmentioning

confidence: 99%

Noninvasive assessment of renal fibrosis by magnetic resonance imaging and ultrasound techniques

Jiang

Ferguson

Lerman

2019

Translational Research

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Renal fibrosis is a useful biomarker for diagnosis and guidance of therapeutic interventions of chronic kidney disease (CKD), a worldwide disease that affects more than 10% of the population and is one of the major causes of death. Currently, tissue biopsy is the gold standard for assessment of renal fibrosis. However, it is invasive, and prone to sampling error and observer variability, and may also result in complications. Recent advances in diagnostic imaging techniques, including magnetic resonance imaging (MRI) and ultrasonography, have shown promise for noninvasive assessment of renal fibrosis. These imaging techniques measure renal fibrosis by evaluating its impacts on the functional, mechanical, and molecular properties of the kidney, such as water mobility by diffusion MRI, tissue hypoxia by blood oxygenation level dependent MRI, renal stiffness by MR and ultrasound elastography, and macromolecule content by magnetization transfer imaging. Other MR techniques, such as T 1 /T 2 mapping and susceptibility-weighted imaging have also been explored for measuring renal fibrosis. Promising findings have been reported in both preclinical and clinical studies using these techniques. Nevertheless, limited specificity, sensitivity, and practicality in these techniques may hinder their immediate application in clinical routine. In this review, we will introduce methodologies of these techniques, outline their applications in fibrosis imaging, and discuss their limitations and pitfalls.

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Section: Blood Oxygenation Level Dependent Mri Principlesmentioning

confidence: 99%

Noninvasive assessment of renal fibrosis by magnetic resonance imaging and ultrasound techniques

Jiang

Ferguson

Lerman

2019

Translational Research

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“…Several MRI techniques, including blood oxygenation leveldependent (BOLD) MRI, [32][33][34] diffusion-weighted MRI, 35,36 and MR elastography (MRE) 37,38 have shown promise for measuring renal fibrosis. Nevertheless, BOLD 31 and diffusion 35,39,40 MRI are limited by low specificity, and might be affected by fibrosis-independent changes in renal structure and function.…”

Section: Mri Techniques For Renal Fibrosis and Limitationsmentioning

confidence: 99%

Quantitative Magnetization Transfer Detects Renal Fibrosis in Murine Kidneys With Renal Artery Stenosis

Jiang

Fang

Ferguson

et al. 2020

Magnetic Resonance Imaging

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Background Renal fibrosis is a common pathway in tubulointerstitial injury and a major determinant of renal insufficiency. Collagen deposition, a key feature of renal fibrosis, may serve as an imaging biomarker to differentiate scarred from healthy kidneys. Purpose To test the feasibility of using quantitative magnetization transfer (qMT), which assesses tissue macromolecule content, to measure renal fibrosis. Study Type Prospective. Animal Model Fifteen 129S1 mice were studied 4 weeks after either sham (n = 7) or unilateral renal artery stenosis (RAS, n = 8) surgeries. Field Strength/Sequence Magnetization transfer (MT)‐weighted images were acquired at 16.4T using an MT‐prepared fast‐low‐angle‐shot sequence. Renal B0, B1, and T1 maps were also acquired, using a dual‐echo gradient echo, an actual flip angle, and inversion recovery method, respectively. Assessment A two‐pool model was used to estimate the bound water fraction (f) and other tissue imaging biomarkers. Masson's trichrome staining was subsequently performed ex vivo to evaluate renal fibrosis. Statistical Tests Comparisons of renal parameters between sham and RAS were performed using independent samples t‐tests. Pearson's correlation was conducted to investigate the relationship between renal fibrosis by histology and the qMT‐derived bound pool fraction f. Results The two‐pool model provided accurate fittings of measured MT signal. The qMT‐derived f of RAS kidneys was significantly increased compared to sham in all kidney zones (renal cortex [CO], 7.6 ± 2.4% vs. 4.6 ± 0.6%; outer medulla [OM], 8.2 ± 4.2% vs. 4.2 ± 0.9%; inner medulla [IM] + P, 5.8 ± 1.6% vs. 2.9 ± 0.6%, all P < 0.05). Measured f correlated well with histological fibrosis in all kidney zones (CO, Pearson's correlation coefficient r = 0.95; OM, r = 0.93; IM + P, r = 0.94, all P < 0.05). Data Conclusion The bound pool fraction f can be quantified using qMT at 16.4T in murine kidneys, increases significantly in fibrotic RAS kidneys, and correlates well with fibrosis by histology. Therefore, qMT may constitute a valuable tool for measuring renal fibrosis in RAS. Level of Evidence 1 Technical Efficacy Stage 3

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“…These results might be because of the decreased deoxygenated hemoglobin in the medulla of the msRI group, which caused the increase of blood oxygen levels. Previous studies have found that, in the rabbit unilateral ureteral obstruction model, as the kidney damage increased and the fibrotic area expanded, the cortical and medullary SWI signal decreased (7), and the blood oxygen level gradually decreased (28). However, in patients with diabetic nephropathy, the changes in renal blood oxygen levels are more complicated.…”

Section: Discussionmentioning

confidence: 96%

Susceptibility weighted imaging (SWI) for evaluating renal dysfunction in type 2 diabetes mellitus: a preliminary study using SWI parameters and SWI-based texture features

et al. 2020

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Background: Susceptibility weighted imaging (SWI) could reflect tissue blood oxygen levels, and then whether it could be used to evaluate renal injury remains to be further studied. This study aimed to examine the performance of SWI parameters and SWI-based texture features in evaluating renal dysfunction of type 2 diabetes mellitus (T2DM).Methods: Forty-five patients with T2DM were included. With the estimated glomerular filtration rate (eGFR), the patients were divided into non-moderate-severe renal injured group (non-msRI, eGFR >60 mL/min/1.73 m 2 ) and moderate-severe renal injured group (msRI, eGFR ≤60 mL/min/1.73 m 2 ). The 3 SWI parameters and 16 SWI-based texture features between non-msRI and msRI were compared. The correlation between the parameters and BUN, Scr was analyzed. Results:The signal intensity ratio of the medulla to psoas muscle (MPswi) was significantly lower than the signal intensity ratio of the cortex to psoas muscle (CPswi) in non-msRI and msRI group (t=8.619, 3.483, respectively, P<0.05). MPswi was higher, and the signal intensity ratio of the cortex to the medulla (CMswi), Skewness, Correlation were lower in msRI than in non-msRI (P<0.05). These parameters showed similar diagnostic efficacies for msRI (P>0.05), and AUCs were 0.703-0.854. CMswi was an independent protective factor for msRI (OR =0.026, P=0.003). MPswi and CMswi were correlated with BUN (r=0.416, −0.545, P<0.05). CMswi and Correlation were correlated with Scr (r=−0.645, −0.411, P<0.05).Conclusions: SWI was valuable for assessing renal dysfunction, which may be helpful for the evaluation of moderate-severe renal injured patients with T2DM.

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Evaluating Renal Fibrosis with R2* Histogram Analysis of the Whole Cortex in a Unilateral Ureteral Obstruction Model

Cited by 14 publications

References 32 publications

Noninvasive assessment of renal fibrosis by magnetic resonance imaging and ultrasound techniques

Noninvasive assessment of renal fibrosis by magnetic resonance imaging and ultrasound techniques

Quantitative Magnetization Transfer Detects Renal Fibrosis in Murine Kidneys With Renal Artery Stenosis

Susceptibility weighted imaging (SWI) for evaluating renal dysfunction in type 2 diabetes mellitus: a preliminary study using SWI parameters and SWI-based texture features

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