Value of T2 Mapping in the Dynamic Evaluation of Renal Ischemia-Reperfusion Injury

Chen, Jing; Chen, Qin; Zhang, Jinggang; Pan, Liang; Zha, Tingting; Zhang, Yongcheng; Chen, Jie

doi:10.1016/j.acra.2021.03.004

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…The susceptibility values of the outer medulla were negatively correlated with cell edema and the average optical density of GPX4. The results were consistent with those of previous studies (15,22). At the IRI-1h time point, the outer medulla was mainly characterized by cell edema.…”

Section: Discussionsupporting

confidence: 93%

“…In the sham group, only the procedure of exposing the kidney was performed without clamping the renal pedicle. Previous studies confirmed that the renal pathophysiology significantly changes at 12 and 24 h after reperfusion, and AKI was the most severe at 48 h after reperfusion (15)(16)(17). A time point of 1 h after reperfusion was chosen to observe the changes at the beginning of reperfusion.…”

Section: Animal Modelmentioning

confidence: 99%

See 1 more Smart Citation

Renal ischemia-reperfusion injury in rabbits evaluated with quantitative susceptibility mapping: an animal study

Luo¹,

Yu²,

Fu³

et al. 2023

Quant Imaging Med Surg

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Background: There were no effective noninvasive methods to diagnose renal ischemia-reperfusion injury (IRI), which is a major clinical problem. The objective of this study was to explore the feasibility of the quantitative susceptibility mapping (QSM) technique in evaluating the dynamic changes in the renal IRI process.Methods: A total of 36 New Zealand rabbits were randomly assigned to the IRI group (n=30) and the sham group (n=6). All rabbits underwent magnetic resonance imaging (MRI) examination, including T2weighted imaging and QSM before the operation (pre-IRI) and 1, 12, 24, and 48 h after the operation (IRI-1h, IRI-12h, IRI-24h, and IRI-48h, respectively). Regions of interest were manually delineated in the outer medulla. All specimens were stained with hematoxylin and eosin (HE) and glutathione peroxidase 4 (GPX4).The pathological score of renal injury and the average optical density value of GPX4 were calculated. The repeated measurement analysis of variance (ANOVA) and Spearman correlation analysis were used to compare the differences between the susceptibility values and determine the correlation.Results: In the IRI group, the susceptibility values of the outer medulla at the pre-IRI, IRI-1h, IRI-12h, IRI-24h, and IRI-48h time points were (42.83±7.83)×10 −3 , (−5.33±6.28)×10 −3 , (6.50±3.94)×10 −3 , (12.00±3.74)×10 −3 , and (22.00±6.81)×10 −3 ppm, respectively. The susceptibility values significantly differed among the different time points (P<0.001). The susceptibility values had a negative correlation with the scores of cell edema (ρ=−0.61; P=0.002) and the average optical density value of GPX4 (ρ=−0.70; P<0.001).The susceptibility values had a positive correlation with iron content (ρ=0.79; P<0.001), the scores of cell necrosis (ρ=0.71; P<0.001), interstitial inflammation (ρ=0.60; P=0.002), cast (ρ=0.75; P<0.001), and the total pathological score of renal injury (ρ=0.51; P=0.01).Conclusions: QSM can be used as a noninvasive method to assess the dynamic changes of the outer medulla in the early stage of renal IRI in rabbits.

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Section: Discussionsupporting

confidence: 93%

Section: Animal Modelmentioning

confidence: 99%

Renal ischemia-reperfusion injury in rabbits evaluated with quantitative susceptibility mapping: an animal study

Luo¹,

Yu²,

Fu³

et al. 2023

Quant Imaging Med Surg

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“…T2 mapping can be a valuable tool in monitoring acute renal injury induced by ischemia–reperfusion, as T2 values positively correlate with tubular epithelial edema ( r = 0.686, P < 0.001) 86 . In Greite R et al's study, they found that T2‐increase and ADC‐reduction on Day 1 correlated with kidney volume loss on Day 14 after ischemia induced AKI in mice ( r = 0.7, P < 0.05; r = 0.6, P < 0.05), and hence could serve as predictive markers 56 .…”

Section: Novel Imaging Biomarkers In Aki and Long‐term Injurymentioning

confidence: 99%

Multiparametric Magnetic Resonance Investigations on Acute and Long‐Term Kidney Injury

Wang

et al. 2023

Magnetic Resonance Imaging

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Acute kidney injury (AKI) is a frequent complication of critical illness and carries a significant risk of short‐ and long‐term mortality. The prediction of the progression of AKI to long‐term injury has been difficult for renal disease treatment. Radiologists are keen for the early detection of transition from AKI to long‐term kidney injury, which would help in the preventive measures. The lack of established methods for early detection of long‐term kidney injury underscores the pressing needs of advanced imaging technology that reveals microscopic tissue alterations during the progression of AKI. Fueled by recent advances in data acquisition and post‐processing methods of magnetic resonance imaging (MRI), multiparametric MRI is showing great potential as a diagnostic tool for many kidney diseases. Multiparametric MRI studies offer a precious opportunity for real‐time noninvasive monitoring of pathological development and progression of AKI to long‐term injury. It provides insight into renal vasculature and function (arterial spin labeling, intravoxel incoherent motion), tissue oxygenation (blood oxygen level‐dependent), tissue injury and fibrosis (diffusion tensor imaging, diffusion kurtosis imaging, T1 and T2 mapping, quantitative susceptibility mapping). The multiparametric MRI approach is highly promising but the longitudinal investigation on the transition of AKI to irreversible long‐term impairment is largely ignored. Further optimization and implementation of renal MR methods in clinical practice will enhance our comprehension of not only AKI but chronic kidney diseases. Novel imaging biomarkers for microscopic renal tissue alterations could be discovered and benefit the preventative interventions. This review explores recent MRI applications on acute and long‐term kidney injury while addressing lingering challenges, with emphasis on the potential value of the development of multiparametric MRI for renal imaging on clinical systems.Evidence Level1Technical EfficacyStage 2

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“…18,19 T 1 and T 2 mapping has also been used to observe psychological and inflammatory responses in the renal ischemic state. 20,21 Diffusion-weighted imaging (DWI) has served as a surrogate measurement of IRI severity based on the apparent diffusion coefficient (ADC). 22 Generalized quantitative magnetization transfer (qMT) has been developed to measure intrinsic MT effects, such as the pool size ratio (PSR), which is associated with the changes in collagen fibers in the liver and kidney.…”

mentioning

confidence: 99%

“…An MRI‐based blood oxygen level‐dependent (BOLD) technique has been used to evaluate blood pO 2 concentration in the early stages of renal ischemia and hypoxia 18,19 . T 1 and T 2 mapping has also been used to observe psychological and inflammatory responses in the renal ischemic state 20,21 . Diffusion‐weighted imaging (DWI) has served as a surrogate measurement of IRI severity based on the apparent diffusion coefficient (ADC) 22 .…”

mentioning

confidence: 99%

Multi‐Parametric MRI for Evaluating Variations in Renal Structure, Function, and Endogenous Metabolites in an Animal Model With Acute Kidney Injury Induced by Ischemia Reperfusion

Tao,

Zhang,

et al. 2023

Magnetic Resonance Imaging

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BackgroundIschemia reperfusion injury (IRI)‐induced acute kidney injury (AKI) may occur after renal ischemic injury. There is a lack of an accurate and comprehensive detection technique for IRI‐AKI.PurposeTo longitudinally evaluate IRI‐AKI in rats by renal structure, function, and metabolites using multi‐parametric MRI (mpMRI).Study TypeProspective.Animal ModelForty‐eight rats undergoing IRI‐AKI.Field Strength/Sequence7‐T, T1 mapping, and arterial spin labeling (ASL): echo planar imaging (EPI) sequence; blood oxygen level‐dependent (BOLD): gradient recalled echo (GRE) sequence; T2 mapping, quantitative magnetization transfer (qMT), and chemical exchange saturation transfer (CEST): rapid acquisition with relaxation enhancement (RARE) sequence.AssessmentThe mpMRI for IRI‐AKI was conducted at 0 (control), 1, 3, 7, 14, and 28 days, all included eight rats. The longitudinal mpMRI signal of manually outlined cortex, outer stripe of the outer medulla (OSOM), inner stripe of the outer medulla, and medulla plus pelvis were calculated and compared, their diagnosis performance for IRI‐AKI also been evaluated.Statistical TestsPearson correlations analysis for correlation between mpMRI signal and renal injury, unpaired t‐tests for comparing the signal changes, and receiver operating characteristics (ROC) analysis was used to identify most sensitive indicator of mpMRI. A P‐value <0.05 was considered statistically significant.ResultsCompared with control kidneys, the T1 and T2 values of the cortex and medulla in IRI kidneys increased and reached their highest values on day 14, and the kidneys also showed the most severe edema and segments blurred. The RBF in the cortex and OSOM showed a significant decline after day 3. The BOLD signal in the OSOM largest increased on day 28. The cortical PSR and the amine‐CEST both decreased with IRI‐AKI progression, and amine‐CEST achieved the highest AUC for the diagnosis (0.899).Data ConclusionMulti‐parametric MRI may show comprehensive variations in IRI‐AKI, and amine‐CEST may exhibit the highest accuracy for diagnosis of IRI‐AKI.Level of Evidence1Technical EfficacyStage 2

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Value of T2 Mapping in the Dynamic Evaluation of Renal Ischemia-Reperfusion Injury

Cited by 7 publications

References 28 publications

Renal ischemia-reperfusion injury in rabbits evaluated with quantitative susceptibility mapping: an animal study

Renal ischemia-reperfusion injury in rabbits evaluated with quantitative susceptibility mapping: an animal study

Multiparametric Magnetic Resonance Investigations on Acute and Long‐Term Kidney Injury

Multi‐Parametric MRI for Evaluating Variations in Renal Structure, Function, and Endogenous Metabolites in an Animal Model With Acute Kidney Injury Induced by Ischemia Reperfusion

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