Renal artery blood flow: quantification with breath-hold or respiratory triggered phase-contrast MR imaging

Haan, Michiel W. de; Kouwenhoven, Marc; Kessels, Alfons G.H.; Engelshoven, Jos M. A. van

doi:10.1007/s003300000362

Cited by 30 publications

(26 citation statements)

References 23 publications

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“…Because these substances rely on almost total clearance from the blood by filtration and tubular excretion to determine blood flow, they are inaccurate in the setting of severe glomerular and tubular dysfunction, shown by the large discrepancy with Doppler flowmeter or phase-contrast cinemagnetic resonance imaging blood flow values. [193][194][195] Thus, studies of RBF in the setting of ARF need to be repeated using methods independent of tubular influence. One such study of renal transplants found a decrease in renal plasma flow postoperative day 7 in patients with sustained renal failure compared with those with recovery.…”

Section: Recovery From Arfmentioning

confidence: 99%

Pathophysiology of renal disease associated with liver disorders: Implications for liver transplantation. Part I

Davis

Gonwa

Wilkinson

2002

Liver Transplantation

117

131

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Section: Recovery From Arfmentioning

confidence: 99%

Pathophysiology of renal disease associated with liver disorders: Implications for liver transplantation. Part I

Davis

Gonwa

Wilkinson

2002

Liver Transplantation

117

131

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“…However, in a previously published study we have shown that quantitative measurement of renal artery blood flow with 2D PC MR is highly reproducible. 12 Still, the spread of MR results in the current study calls for further improvements before widespread clinical application of this technique can be advocated.…”

Section: Discussionmentioning

confidence: 93%

“…The accuracy of this technique was verified both in vivo and in vitro by comparison with other noninvasive (eg, duplex ultrasound and/or nuclear clearance techniques) and invasive techniques (implantation of ultrasound probes) or by internal validation by comparing aortic flow measurements above the renal arteries with the total flow through the renal arteries and aorta distal of these arteries. [12][13][14] In the current study, the 133 Xenon washout technique was used as an independent test for comparative evaluation of the acquired 2D PC MR renal artery flow data in hypertensive patients. The 133 Xenon washout technique requires selective arterial catheterization to allow local disposition of the tracer and therefore has the potential to provide information about blood flow of each kidney separately.…”

mentioning

confidence: 99%

Phase-Contrast Magnetic Resonance Flow Quantification in Renal Arteries

et al. 2003

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Abstract-To assess the accuracy of 2D phase-contrast magnetic resonance (2D PC MR) renal artery flow measurements, data obtained with this technique were compared with those acquired with the 133 Xenon-washout procedure. In addition, the 2D PC MR flow data were related to functional renal information as derived from selective arterial and venous renin sampling. In 53 patients suspected of having renovascular hypertension, MR angiography of the renal arteries was performed, followed by a 3-step angiographic procedure: (1) selective venous and arterial renin sampling; (2) assessment of the renal blood flow by means of the 133 Xenon washout technique, and (3) conventional renal angiography. After initial assessment, 71 kidneys were left for analysis. The overall prevalence of renovascular disease Ն50% stenosis was 18%. Mean renal blood flow as assessed with the 2D PC MR technique showed a significant correlation with the 133 Xenon washout flow measurements, with a Pearson correlation coefficient of 0.69 (2-tailed; PϽ0.01). PC MR blood flow measurements correlated poorly with the presence and/or severity of renovascular disease on conventional angiography (rϭ0.1, Pϭ0.36). Likewise, no statistically significant correlation with either renal venous renin levels or the renin ratio could be identified. Measurement of renal artery blood flow with the use of a 2D PC MR technique is technically feasible. However, the mean renal artery blood flow correlates poorly with either the presence of renovascular disease on angiography or with renin levels. Further improvement of this technique is necessary before it can be applied on a larger scale.

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“…Renal blood fl ow measurements by cine phase-contrast MRI are well correlated with simultaneous PAH clearance measurement [50] and the results are reproducible [51]. King et al [52] used this met hod as a tool to predic t clinical re sponse afte r percutaneous angioplasty in re nal artery stenosis.…”

Section: Cine Phase-contrast Mrimentioning

confidence: 99%

Measurement of Kidney Perfusion in Critically Ill Patients

Schneider

Goodwin

Bellomo

2013

Annual Update in Intensive Care and Emergency Medicine 2013

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Acute kidney injury (AKI) is a major complication of critical illness [1] occurring in 30 to 40 % of all critically ill patients and in its sev ere form requires renal replacement therapy (RRT), in approximately 5 % of patients [2]. AKI has been s hown to be an independent predictor for mortality [3] and is associated with invasive therapy and substantial costs [4].Despite its impor tance, the pathoph ysiology of AKI is still poorly understood. AKI is most commonly associated with systemic diseases, such as septic shock, major surgery and cardiogenic shock [1], but a specifi c mechanism causing AKI to develop in specifi c patients can rarely be determined. Since the early description of an "acute uremia syndrome" in crush injury victims during World War II [5,6] and its association with histopathological fi ndings similar to those found in experimental renal artery ligation, ischemia or some form of alteration in renal blood fl ow has been thought to play a pivotal role in the pathogenesis of AKI. Th is paradigm that essentially all AKI in critically ill patients is the result of some form or degree of ischemia remains of continuing conceptual dominanc e to this day [7]. Despite such dominance, there are only very limited data supporting this concept. In a recent systematic review, Prowle et al. [8] highlighted the extraordinary fact that renal blood fl ow measurement, irrespective of the technique used, has only been reported in 46 critically ill patients (fi ve studies) within the last sixty years. Th us, our knowledge, understanding, and theoretical constructs regarding global renal perfu sion in critically ill patients with RRT-treated AKI (an estimated 5 % of all ICU admissions for a total of approximately a quarter of a million such patients each year in developed countries alone) is, like an inverted pyramid, based on extremely weak evidence.Furthermore, given the complex and heterogeneous nature of the renal vasculature, evaluating the fl ow in the main renal arteries (macrocirculation) might not provide suffi cient information to adequately understand perfusion alterations in complex diseases, such as septic or cardio genic shock. Indeed, some pathophysiological processes may be associated with increased global renal blood fl ow [9,10] despite loss of f un ction. In such instances, there is experimental evidence that, at least in sepsis, this phenomenon may be caused by intra-renal shunting [11]. Hence, correlation between macroscopic renal blood fl ow and function is far from linear. Th erefore, techniques allowing the study of microcircu latory parameters, such as cortico-med ullary perfusion ratio and regional tissue oxygenation measurement, and assessment of their relative change over time may be more valuable in increasing our understanding of the pathophysiology of AKI.In this state-of-the art review, we discuss the value, challenges, limitations, safety and feasibility of diff erent techniques for the measurement of kidney perfusion in critically ill patients. Th e advantages of each technique wi...

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Renal artery blood flow: quantification with breath-hold or respiratory triggered phase-contrast MR imaging

Cited by 30 publications

References 23 publications

Pathophysiology of renal disease associated with liver disorders: Implications for liver transplantation. Part I

Pathophysiology of renal disease associated with liver disorders: Implications for liver transplantation. Part I

Phase-Contrast Magnetic Resonance Flow Quantification in Renal Arteries

Measurement of Kidney Perfusion in Critically Ill Patients

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