Functional MRI of the kidneys

Zhang, Jeff L.; Rusinek, Henry; Chandarana, Hersh; Lee, Vivian S.

doi:10.1002/jmri.23717

Cited by 75 publications

(81 citation statements)

References 95 publications

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“…When overt proteinuria occurs, histopathologic abnormalities are often far advanced. Progressive glomerulosclerosis and tubulointerstitial fibrosis formed in the later stages may also restrict water diffusion (19). In line with these changes in renal tissue composition, in our study, we found that significant decrease in renal ADC values appear in stage 3 of diabetic nephropathy, and diffusion restriction in renal parenchyma becomes more prominent in endstage kidney disease.…”

Section: Discussionsupporting

confidence: 86%

Renal diffusion-weighted imaging in diabetic nephropathy: correlation with clinical stages of disease

Çakmak¹,

Yağcı²,

Dursun³

et al. 2014

Diagn Interv Radiol

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Original Article PURPOSE We aimed to assess the correlation between renal apparent diffusion coefficient (ADC) values measured by diffusion-weighted imaging (DWI) and the clinical stages of diabetic nephropathy. MATERIALS AND METHODS DWI (b value, 0 and 600 s/mm2 ) was performed in 78 patients with clinically confirmed diabetic nephropathy (study group) and 22 volunteers without diabetes mellitus or any renal disease (control group). The mean ADCs were calculated from multiple region-of-interest circles positioned in the renal cortex. Diabetic nephropathy was clinically categorized into five stages based on the values of urinary albumin excretion and glomerular filtration rate (GFR). RESULTSMean renal ADC values of patients with stage 3 or 4 disease were significantly lower than those in patients with stage 1 or 2 disease and the control group (P < 0.001). ADC values of patients with stage 5 disease were significantly lower than those in patients with stage 4 (P = 0.003), stage 3 (P = 0.020), stages 2 and 1, and the control group (P < 0.001). Significant correlations were found between mean renal ADC values and clinical stages of diabetic nephropathy (r=−0.751, P < 0.001), between mean renal ADC values and estimated GFR values (r=0.642, P < 0.001), and between mean renal ADC values and urinary albumin excretion (r=−0.419, P < 0.001). CONCLUSIONRenal ADC values show a significant correlation with clinical stages of diabetic nephropathy. As a relatively simple and noninvasive tool without contrast media administration, renal quantitative DWI may potentially play a role in making clinical decisions in the follow-up of diabetic patients. Diabetic nephropathy is classically defined as a clinical syndrome characterized by persistent albuminuria, a relentless decline in glomerular filtration rate (GFR) progressing to end-stage renal disease, raised arterial blood pressure, and enhanced cardiovascular morbidity and mortality (1). In diabetic patients, renal functional deterioration is the result of heterogeneous renal structural changes, including glomerular basal membrane thickening and mesangial expansion, extracellular matrix accumulation, mesangiolysis, reduced podocyte number, microaneurysm formation, arteriolar hyalinosis which ultimately leads to glomerulosclerosis, tubular atrophy, interstitial expansion, and fibrosis (2). Renal damage occurs in multiple stages. Throughout its early stages, diabetic nephropathy has no symptoms. Persistent microalbuminuria is a predictor of the development of clinical nephropathy. Microalbuminuria has been proposed as a marker of widespread endothelial dysfunction and indicates microvascular damage (3). Better understanding of the mechanisms that lead to structural and functional changes in the diabetic kidney may facilitate the development of more effective follow-up and treatment modalities. Diagnostic tests that help identify early microvascular damage at an early stage will provide significant benefits to get the disease under control. Quantitative diffusion-weighted magnetic...

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Section: Discussionsupporting

confidence: 86%

Renal diffusion-weighted imaging in diabetic nephropathy: correlation with clinical stages of disease

Çakmak¹,

Yağcı²,

Dursun³

et al. 2014

Diagn Interv Radiol

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“…The present study evaluated 4 non-contrast MRI modalities, and the results showed that T1rho is significantly prolonged in LN patients compared to healthy volunteers, and T1rho in medulla alone yields 95% accuracy for the differentiation between LN and HN groups in the cohort of 20 subjects. The biophysical mechanism underlying T1rho MRI is thought to be related to the proton exchange and dipole-dipole interactions between the free water pool and macromolecules (such as collagen and proteoglycan [29]). Increased T1rho has been reported in animal models of liver fibrosis with the degree of fibrosis correlated with the degree of increase in T1rho measurements [15].…”

Section: Discussionmentioning

confidence: 99%

Towards the identification of multi-parametric quantitative MRI biomarkers in lupus nephritis

Rapacchi

Smith

Wang

et al. 2015

Magnetic Resonance Imaging

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Keywords:Renal function Multi-parametric quantitative MRI (qMRI) Arterial spin labeling (ASL) Blood oxygen level dependent (BOLD) T1rho MRI Lupus nephritis (LN) Purpose: To identify potential biomarkers of the renal impairment in lupus nephritis using a multi-parametric renal quantitative MRI (qMRI) protocol including diffusion weighted imaging (DWI), blood oxygen level dependent (BOLD), arterial spin labeling (ASL) and T1rho MRI between a cohort of healthy volunteers and lupus nephritis (LN) patients. Materials and methods: The renal qMRI protocol was performed twice with repositioning in between on 10 LN patients and 10 matched controls at 1.5 T. Navigator-gated and breath-hold acquisitions followed by non-rigid image registration were used to control respiratory motion. The repeatability of the 4 MRI modalities was evaluated with the intra-class correlation coefficient (ICC) and within-subject coefficient of variation (wsCV). Unpaired t-test and stepwise logistic regression were carried out to evaluate qMRI parameters between the LN and control groups. Results: The reproducibility of the 4 qMRI modalities ranged from moderate to good (ICC = 0.4-0.91, wsCV ≤ 12%) with a few exceptions. T1rho MRI and ASL renal blood flow (RBF) demonstrated significant differences between the LN and control groups. Stepwise logistic regression yielded only one significant parameter (medullar T1rho) in differentiating LN from control groups with 95% accuracy. Conclusion: A reasonable degree of test-retest repeatability and accuracy of a multi-parametric renal qMRI protocol has been demonstrated in healthy volunteers and LN subjects. T1rho and ASL RBF are promising imaging biomarkers of LN.

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“…Another potentially useful tool in analyzing the effect of RDN on the kidney is diffusion-weighted MR imaging (56,57). This technology measures water diffusion in cortical or medullary tissue, and this diffusion may be an early marker of renal disease.…”

Section: Imaging Of Rsnamentioning

confidence: 99%

“…This technology measures water diffusion in cortical or medullary tissue, and this diffusion may be an early marker of renal disease. Differences in split kidney function may be helpful in identifying RDN candidates or measuring asymmetric responses to RDN (56)(57)(58). However, preliminary studies indicate that this technique is not useful for identifying early microvascular changes of HTN (56).…”

Section: Imaging Of Rsnamentioning

confidence: 99%

Proceedings from the Society of Interventional Radiology Foundation Research Consensus Panel on Renal Sympathetic Denervation

Angle

Prince

Matsumoto

et al. 2014

Journal of Vascular and Interventional Radiology

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ABBREVIATIONSBP = blood pressure, CHF = congestive heart failure, HTN = hypertension, MSNA = muscle sympathetic nerve activity, NE = norepinephrine, LV = left ventricular, OSA = obstructive sleep apnea, PET = positron emission tomography, PAREPET = prediction of arrhythmic events with positron emission tomography, RCP = research consensus panel, RDN = renal denervation, RSNA = renal sympathetic nerve activity

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Functional MRI of the kidneys

Cited by 75 publications

References 95 publications

Renal diffusion-weighted imaging in diabetic nephropathy: correlation with clinical stages of disease

Renal diffusion-weighted imaging in diabetic nephropathy: correlation with clinical stages of disease

Towards the identification of multi-parametric quantitative MRI biomarkers in lupus nephritis

Proceedings from the Society of Interventional Radiology Foundation Research Consensus Panel on Renal Sympathetic Denervation

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