Renal BOLD-MRI does not reflect renal function in chronic kidney disease

Michaely, Henrik J.; Metzger, L.C.; Haneder, Stefan; Hansmann, Jan; Schoenberg, Stefan O.; Attenberger, Ulrike

doi:10.1038/ki.2011.455

Cited by 124 publications

(107 citation statements)

References 28 publications

(42 reference statements)

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“…A recent study showed that the basal cortical and medullary BOLD signal was nonspecific for discriminating patients in a large cohort with diverse chronic renal diseases (37). These observations subsequently raised methodological questions (38), because BOLD uses deoxyhemoglobin as the contrast agent, and pathologic conditions (e.g., anemia or ischemia) that affect the hematocrit, microvascular density, or regional renal blood volume may nonuniformly influence the signal in a heterogynous population (39).…”

Section: Blood Oxygen Level-dependent Mrimentioning

confidence: 99%

“…The severity of the artifact increases at higher magnetic fields, and warrants careful selection of regions of interest. Notably, analytical methods utilizing histogram-based tools that recognize the variability of the BOLD signal intensity within the regions of interest may be capable of detecting differences (40) and introduce new markers beyond the traditional mean of R 2 * value, such as their distribution (41,42).…”

Section: Blood Oxygen Level-dependent Mrimentioning

confidence: 99%

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Renal Relevant Radiology

Ebrahimi

Textor

Lerman

2014

Clinical Journal of the American Society of Nephrology

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SummaryBecause of its noninvasive nature and provision of quantitative measures of a wide variety of physiologic parameters, functional magnetic resonance imaging (MRI) shows great potential for research and clinical applications. Over the past decade, application of functional MRI extended beyond detection of cerebral activity, and techniques for abdominal functional MRI evolved. Assessment of renal perfusion, glomerular filtration, interstitial diffusion, and parenchymal oxygenation turned this modality into an essential research and potentially diagnostic tool. Variations in many renal physiologic markers can be detected using functional MRI before morphologic changes become evident in anatomic magnetic resonance images. Moreover, the framework of functional MRI opened a window of opportunity to develop novel pathophysiologic markers. This article reviews applications of some well validated functional MRI techniques, including perfusion, diffusion-weighted imaging, and blood oxygen level-dependent MRI, as well as some emerging new techniques such as magnetic resonance elastography, which might evolve into clinically useful tools.

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Section: Blood Oxygen Level-dependent Mrimentioning

confidence: 99%

Section: Blood Oxygen Level-dependent Mrimentioning

confidence: 99%

Renal Relevant Radiology

Ebrahimi

Textor

Lerman

2014

Clinical Journal of the American Society of Nephrology

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“…However, as stated by the authors, a main limitation of the study can be seen in the heterogeneous patient population [43].…”

Section: Applicationsmentioning

confidence: 99%

“…In a study performed to evaluate renal function using BOLD MRI in patients affected by chronic kidney disease, Michaely et al [43] concluded that BOLD MRI is not able to reflect different stages of renal insufficiency. However, as stated by the authors, a main limitation of the study can be seen in the heterogeneous patient population [43].…”

Section: Applicationsmentioning

confidence: 99%

Clinical Functional MRI of the kidneys

2013

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In functional renal magnetic resonance imaging (MRI), advanced techniques are applied to obtain information on a functional and molecular level from the kidney tissue beyond pure morphology. Techniques such as diffusion-weighted and diffusion tensor imaging, arterial spin labelling, and blood oxygenation level-dependent imaging provide potential biomarkers of organ function. Moreover, dynamic contrast-enhanced techniques after the intravenous injection of gadolinium-chelates may be used to assess glomerular filtration and urinary excretion. This review summarizes recent developments of contrast-and non-contrast-enhanced MRI techniques for assessment of renal function in a clinical setting. The physiological background and the sequence techniques are described in detail. Potential clinical applications of the different techniques are discussed regarding their potential usefulness in the assessment of parenchymal diseases, urinary tract anomalies, transplant kidney function, and renal masses.

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“…The signal of BOLD imaging is based on the different magnetic properties of oxyhemoglobin and deoxyhemoglobin and thus allows an indirect estimation of the relative local oxygen concentration. This technique is currently subject of research and has not yet established itself in clinical routine [5,6].…”

Section: Blood Oxygenation Level-dependent (Bold) Imagingmentioning

confidence: 99%

Urinary Obstruction, Stone Disease, and Infection

Schönberg

Budjan

Hausmann

2018

IDKD Springer Series

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Acute infection is mostly diagnosed based on clinical presentation and laboratory tests without imaging examinations [1]. Urinary tract infections are regarded as uncomplicated in otherwise healthy patients without structural or functional urinary abnormalities. Complicated urinary tract infections are accompanied by factors that potentially decrease therapy effectiveness, such as immunocompromission, unusually virulent pathogen, and patient-related factors ( ImagingMRI plays an increasingly important role in the diagnostic work-up of urological patients as an alternative or complementary imaging of CT. However, on the one hand, the availability of MRI scanners is lower than that of CT scanners, and on the other hand, the cost of an MRI is significantly higher than that of a CT scan. In emergency situations, such as trauma, acute bleeding, or renal colic with suspected underlying urolithiasis, CT is the imaging modality of choice.MRI examinations usually require more patient cooperation than CT examinations. Non-compliance can significantly affect the image quality and thus the diagnostic confidence.Moreover, in the first trimester of pregnancy, MRI should only be performed when absolutely necessary and at lowfield strengths only (1.5 T or less). Certain questions can only be answered to a limited extent, as contrast agents are contraindicated during pregnancy.The narrowing of the MRI tube may lead to additional problems in emergency situations, on the one hand, caused by claustrophobia (if necessary, a premedication with an anxiolytic drug may be considered) and, on the other hand, by obesity.Despite these limitations, owing to the superior soft tissue contrast, MRI can provide useful information as a supplementary modality in the assessment of inflammatory urinary tract diseases. Learning Objectives• To understand indications for imaging and choice of cross-sectional imaging method depending on pathology • To identify "high-risk" patients to develop severe and/or chronic urogenital inflammations • To learn about sequence composition of a "standard" MRI protocol and additional potentially useful functional sequences • To see the MRI appearance of various acute and chronic inflammatory urogenital pathologies • To think of the differential diagnosis (e.g., lymphoma or posttransplant lymphoproliferative disorder)

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Renal BOLD-MRI does not reflect renal function in chronic kidney disease

Cited by 124 publications

References 28 publications

Renal Relevant Radiology

Renal Relevant Radiology

Clinical Functional MRI of the kidneys

Urinary Obstruction, Stone Disease, and Infection

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