Functional Multiparametric Magnetic Resonance Imaging of the Kidneys Using Blood Oxygen Level Dependent and Diffusion-Weighted Sequences

Giannarini, Gianluca; Kessler, Thomas M.; Roth, Beat; Vermathen, Peter; Thoeny, Harriet C.

doi:10.1016/j.juro.2014.02.048

Cited by 7 publications

(5 citation statements)

References 13 publications

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“…We would be more cautious in making such conclusion, as the relationship between R 2 * and tissue oxygenation is complicated by many factors. Similar findings were observed with adult patients before and after removal of acute obstruction of the upper urinary tract 36 . Within six months after the removal, cortical R 2 * increased to normal level, and medullary R 2 * increased slightly.…”

Section: Non-contrast Mrisupporting

confidence: 86%

“…In a mouse study 47 , UUO induced renal fibrosis and reduction in glomeruli, and DWI detected decreases in both diffusion coefficient and perfusion fraction. Similar results were found in patients with acute UUO 36 , by comparing DWI before and after removal of UUO. While all the above studies indicate that DWI-measured diffusion coefficient is associated with renal functional impairment, good correlation was not detected between the DWI parameters and contrast-enhanced MRI measured GFR and RPF 48 .…”

Section: Non-contrast Mrisupporting

confidence: 79%

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Functional Magnetic Resonance Imaging of the Kidneys—With and Without Gadolinium-Based Contrast

Zhang

2017

Advances in Chronic Kidney Disease

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Assessment of renal function with magnetic resonance imaging (MRI) has been actively explored in the past decade. In this review, we introduce the principle of MRI, and review recent progress of MRI methods (contrast-enhanced and non-contrast) in assessing renal function. Contrast-enhanced MRI using ultra-low dose of gadolinium-based agent has been validated for measuring single-kidney glomerular filtration rate (GFR) and renal plasma flow (RPF) accurately. For routine functional test, contrast-enhanced MRI may not replace the simple serum-creatinine method. However, for patients with renal diseases, it is often worthy to perform MRI to accurately monitor renal function, particularly for the diseased kidney. As contrast-enhanced MRI is already an established clinical tool for characterizing renal structural abnormalities, including renal mass and ureteral obstruction, it is possible to adapt the clinical MRI protocol to measure single-kidney GFR and RPF, as demonstrated by recent studies. What makes MRI unique is the promise of its non-contrast methods. These methods include arterial spin labeling (ASL) for tissue perfusion, blood oxygen level dependent (BOLD) for blood and tissue oxygenation, and diffusion weighted imaging (DWI) for water diffusion. For each method, we reviewed recent findings, and summarized challenges.

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Section: Non-contrast Mrisupporting

confidence: 86%

Section: Non-contrast Mrisupporting

confidence: 79%

Functional Magnetic Resonance Imaging of the Kidneys—With and Without Gadolinium-Based Contrast

Zhang

2017

Advances in Chronic Kidney Disease

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“…The previous literature on the predictive nature of SC signal change for the clinical baseline and outcome in patients with SCI is sparse. A detailed literature search of SCI and MRI signal change was performed with a systematic review [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ] ( Table 1 and Table 5 ). Fourteen studies met the inclusion criteria, as defined as being prospective and examining acute SCI, MRI, and adverse events [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ...…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Signal Change on Magnetic Resonance Imaging May Predict Worse Clinical In- and Outpatient Outcomes in Patients with Spinal Cord Injury: A Prospective Multicenter Study in 459 Patients

Jentzsch

Cadotte

Wilson

et al. 2021

JCM

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Prognostic factors for clinical outcome after spinal cord (SC) injury (SCI) are limited but important in patient management and education. There is a lack of evidence regarding magnetic resonance imaging (MRI) and clinical outcomes in SCI patients. Therefore, we aimed to investigate whether baseline MRI features predicted the clinical course of the disease. This study is an ancillary to the prospective North American Clinical Trials Network (NACTN) registry. Patients were enrolled from 2005–2017. MRI within 72 h of injury and a minimum follow-up of one year were available for 459 patients. Patients with American Spinal Injury Association impairment scale (AIS) E were excluded. Patients were grouped into those with (n = 354) versus without (n = 105) SC signal change on MRI T2-weighted images. Logistic regression analysis adjusted for commonly known a priori confounders (age and baseline AIS). Main outcomes and measures: The primary outcome was any adverse event. Secondary outcomes were AIS at the baseline and final follow-up, length of hospital stay (LOS), and mortality. A regression model adjusted for age and baseline AIS. Patients with intrinsic SC signal change were younger (46.0 (interquartile range (IQR) 29.0 vs. 50.0 (IQR 20.5) years, p = 0.039). There were no significant differences in the other baseline variables, gender, body mass index, comorbidities, and injury location. There were more adverse events in patients with SC signal change (230 (65.0%) vs. 47 (44.8%), p < 0.001; odds ratio (OR) = 2.09 (95% confidence interval (CI) 1.31–3.35), p = 0.002). The most common adverse event was cardiopulmonary (186 (40.5%)). Patients were less likely to be in the AIS D category with SC signal change at baseline (OR = 0.45 (95% CI 0.28–0.72), p = 0.001) and in the AIS D or E category at the final follow-up (OR = 0.36 (95% CI 0.16–0.82), p = 0.015). The length of stay was longer in patients with SC signal change (13.0 (IQR 17.0) vs. 11.0 (IQR 14.0), p = 0.049). There was no difference between the groups in mortality (11 (3.2%) vs. 4 (3.9%)). MRI SC signal change may predict adverse events and overall LOS in the SCI population. If present, patients are more likely to have a worse baseline clinical presentation (i.e., AIS) and in- or outpatient clinical outcome after one year. Patients with SC signal change may benefit from earlier, more aggressive treatment strategies and need to be educated about an unfavorable prognosis.

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“…To address this shortcoming, an increasing number of studies employ multi-parametric renal MRI. [42][43][44][45][46][47][48] This study enhances the amount of information by adding the time domain using high-temporal-resolution dynamic T * 2 mapping of the kidney's response to a test stimulus, including but not limited to changes in the inspiratory oxygenation fraction. 49,50 We hypothesize that high-temporal-resolution T * 2 monitoring of a step-like oxygenation stimulus facilitates physiological system analysis of the kidney.…”

Section: Introductionmentioning

confidence: 99%

“…Another reason that is hiding in plain sight might be that such single‐parameter single‐timepoint measurements only provide a limited amount of information about a physiological system as complex as the kidney. To address this shortcoming, an increasing number of studies employ multi‐parametric renal MRI 42‐48 …”

Section: Introductionmentioning

confidence: 99%

Physiological system analysis of the kidney by high‐temporal‐resolution monitoring of an oxygenation step response

Zhao

Pohlmann

Feng

et al. 2020

Magnetic Resonance in Med

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Purpose: Examine the feasibility of characterizing the regulation of renal oxygenation using high-temporal-resolution monitoring of the T * 2 response to a step-like oxygenation stimulus. Methods: For T * 2 mapping, multi-echo gradient-echo imaging was used (temporal resolution = 9 seconds). A step-like renal oxygenation challenge was applied involving sequential exposure to hyperoxia (100% O 2), hypoxia (10% O 2 + 90% N 2), and hyperoxia (100% O 2). In vivo experiments were performed in healthy rats (N = 10) and in rats with bilateral ischemia-reperfusion injury (N = 4). To assess the step response of renal oxygenation, a second-order exponential model was used (model parameters: amplitude [A], time delay [Δt], damping constant [D], and period of the oscillation [T]) for renal cortex, outer stripe of the outer medulla, inner stripe of the outer medulla, and inner medulla. Results: The second-order exponential model permitted us to model the exponential T * 2 recovery and the superimposed T * 2 oscillation following renal oxygenation stimulus. The in vivo experiments revealed a difference in D outer medulla between healthy controls (D < 1, indicating oscillatory recovery) and ischemia-reperfusion injury (D > 1, reflecting aperiodic recovery). The increase in D outer medulla by a factor of 3.7 (outer stripe of the outer medulla) and 10.0 (inner stripe of the outer medulla) suggests that this parameter might be rather sensitive to (patho)physiological oxygenation changes. Conclusion: This study demonstrates the feasibility of monitoring the dynamic oxygenation response of renal tissues to a step-like oxygenation challenge using | 335 ZHAO et Al.

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Functional Multiparametric Magnetic Resonance Imaging of the Kidneys Using Blood Oxygen Level Dependent and Diffusion-Weighted Sequences

Cited by 7 publications

References 13 publications

Functional Magnetic Resonance Imaging of the Kidneys—With and Without Gadolinium-Based Contrast

Functional Magnetic Resonance Imaging of the Kidneys—With and Without Gadolinium-Based Contrast

Spinal Cord Signal Change on Magnetic Resonance Imaging May Predict Worse Clinical In- and Outpatient Outcomes in Patients with Spinal Cord Injury: A Prospective Multicenter Study in 459 Patients

Physiological system analysis of the kidney by high‐temporal‐resolution monitoring of an oxygenation step response

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