Functional dynamic MRI, pharmacokinetics and safety of Gd-DTPA in patients with impaired renal function

Krestin, Gabriël P.; Schuhmann-Giampieri, Gabriele; Haustein, Jens; Friedman, Gary S.; Neufang, Karl; Clauß, W.; Stöckl, B.

doi:10.1007/bf00714176

Cited by 44 publications

(19 citation statements)

References 13 publications

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“…In patients with a clearance below 30 ml/min, no signal decrease is seen anymore indicating the loss of the concentration ability of the kidney (Fig. 7) [13].…”

Section: Renal Insufficiencymentioning

confidence: 97%

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Magnetic resonance in the assessment of renal function

Knesplova

Krestin

1998

Eur Radiol

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The kidneys are the most important organs to maintain homeostasis. In the assessment of renal functional disorders laboratory tests offer only indirect hints on location of the disease; radionuclide nephrography is hampered by low spatial resolution and radiologic methods provide only limited quantitative information. The MRI technique with fast pulse sequences and renally eliminated contrast agent has the capability of combining both anatomic and functional information. This article gives an overview on functional MRI of the kidneys with its possibilities and limitations. The clinical application of functional MRI allows a better understanding of some pathologic conditions such as urinary tract obstruction, renal insufficiency, effects of extracorporeal shock wave lithotripsy, different states of hydration, effects of drugs, vascular disorders, and effects of transplantation.

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“…In patients with a clearance below 30 ml/min, no signal decrease is seen anymore indicating the loss of the concentration ability of the kidney (Fig. 7) [13].…”

Section: Renal Insufficiencymentioning

confidence: 97%

“…In contrast to iodinated contrast agents as used in CT, administration of gadolinium compounds is not contraindicated in patients with impaired renal function [13,39]. Therefore, dynamic contrast-enhanced MRI may be performed even in patients with bilateral renal insufficiency.…”

Section: Renal Insufficiencymentioning

confidence: 98%

Magnetic resonance in the assessment of renal function

Knesplova

Krestin

1998

Eur Radiol

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“…In patients with renal parenchymal diseases dynamic functional studies may be performed using a GRE sequence with simultaneous T1-and T2-influence (GRASS, FFE, FLASH without spoiling gradients). Rapid repetition of 16±32 single scans in the same position with TR = 30 ms, TE = 16 ms, flip angle = 70 using a reduced (190 256) matrix allows a reduction in acquisition times to 5±6 s/slice, which are followed by breathing periods of 4±5 s resulting in a temporal resolution of 10 s. Gd-DTPA or Gd-DOTA are administered after the first scan as a bolus in a concentration of 0.1 mmol/kg body weight [10]. 7.…”

Section: Mr Imaging Strategiesmentioning

confidence: 99%

“…Only when the contrast agent passes into the calyces and is diluted with non-contrasted glomerular filtrate does the SI increase again to approximately equal values as in the cortex. Excretion into the calyces usually may be demonstrated at this point: It is characterized by a SI decrease in the region of the renal pelvis, which is also followed by susceptibility artifacts [1,2,10,11].…”

Section: Normal Morphology and Function Of The Kidneys And Adrenal Glmentioning

confidence: 99%

Genitourinary MR: Kidneys and adrenal glands

Krestin

1999

European Radiology

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Due to its high tissue contrast and multiplanar imaging capabilities, MRI provides a detailed display of renal and adrenal anatomy. Recent technical developments overcoming the problem of respiration induced motion artifacts and the use of paramagnetic contrast agents have further improved the performance of MRI which has now evolved as an alternative or complementary imaging modality to ultrasound, excretory urography and computed tomography. Dynamic contrast-enhanced studies will usually allow to detect even small enhancing solid areas within the cyst wall. Use of a fast (turbo) spoiled gradient echo sequence allows for assessment of contrast enhancement dynamics in renal and adrenal masses. For tumor staging, the multiplanar imaging capabilities of MRI are advantageous. Perinephric extent is best detected using opposed-phase GRE images resulting in an artificial accentuation of renal contours. Extension into venous structures is best diagnosed by using a GRE sequence allowing for distinction between flowing blood and tumor thrombus. Noninvasive differentiation of adrenal lesions can be performed with an unprecedented accuracy using chemical-shift imaging.

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“…The procedure is noninvasive and the gadolinium-based contrast agents used in 3D-Gd-MRA are not nephrotoxic when the correct dosage is used (2,8,9). The clinical value of 3D-Gd-MRA is now well documented (10 -14).…”

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confidence: 99%

Renal artery stenosis: Extracting quantitative parameters with a mathematical model fitted to magnetic resonance blood flow data

Larsson

Persson

Eriksson

et al. 2007

Magnetic Resonance Imaging

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Purpose:To investigate the feasibility of quantitative parameter extraction from a mathematical model fitted to renal artery magnetic resonance flow data. Material and Methods:A total of 16 subjects, eight patients, and eight normal controls, were examined with cine phase-contrast velocity measurements, and blood flow data from the aorta and both renal arteries were extracted by means of contour detection. A mathematical model with eight parameters describing the time, duration, and amplitude of the systolic acceleration and the diastolic deceleration was fitted to the aorta and renal artery blood flow data from each subject. The curve fitting was evaluated with R 2 values. Statistical analysis was performed with unpaired Wilcoxon tests and stepwise logistic regression. Results:A total of three data sets out of 48 yielded R 2 values below 0.80 and were considered unreliable for parameter estimation. Basal flow was significantly, and systolic peak amplitude almost significantly, lower in stenotic arteries. Logistic regression indicated that two parameters describing basal flow and the duration of acceleration can accurately predict stenosis. Conclusion:The results suggest that it is technically feasible to fit a mathematical model to renal blood flow data, extracting quantitative parameters that may prove useful for quantification and diagnosis of renal artery stenosis.

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Functional dynamic MRI, pharmacokinetics and safety of Gd-DTPA in patients with impaired renal function

Cited by 44 publications

References 13 publications

Magnetic resonance in the assessment of renal function

Magnetic resonance in the assessment of renal function

Genitourinary MR: Kidneys and adrenal glands

Renal artery stenosis: Extracting quantitative parameters with a mathematical model fitted to magnetic resonance blood flow data

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