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2017 ; 8
(ä): 696
Nephropedia Template TP
gab.com Text
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English Wikipedia
Multiparametric Renal Magnetic Resonance Imaging: Validation, Interventions, and
Alterations in Chronic Kidney Disease
#MMPMID28959212
Cox EF
; Buchanan CE
; Bradley CR
; Prestwich B
; Mahmoud H
; Taal M
; Selby NM
; Francis ST
Front Physiol
2017[]; 8
(ä): 696
PMID28959212
show ga
Background: This paper outlines a multiparametric renal MRI acquisition and
analysis protocol to allow non-invasive assessment of hemodynamics (renal artery
blood flow and perfusion), oxygenation (BOLD T(2)(*)), and microstructure
(diffusion, T(1) mapping). Methods: We use our multiparametric renal MRI protocol
to provide (1) a comprehensive set of MRI parameters [renal artery and vein blood
flow, perfusion, T(1), T(2)(*), diffusion (ADC, D, D(*), f(p)), and total kidney
volume] in a large cohort of healthy participants (127 participants with mean age
of 41 ± 19 years) and show the MR field strength (1.5 T vs. 3 T) dependence of
T(1) and T(2)(*) relaxation times; (2) the repeatability of multiparametric MRI
measures in 11 healthy participants; (3) changes in MRI measures in response to
hypercapnic and hyperoxic modulations in six healthy participants; and (4) pilot
data showing the application of the multiparametric protocol in 11 patients with
Chronic Kidney Disease (CKD). Results: Baseline measures were in-line with
literature values, and as expected, T(1)-values were longer at 3 T compared with
1.5 T, with increased T(1) corticomedullary differentiation at 3 T. Conversely,
T(2)(*) was longer at 1.5 T. Inter-scan coefficients of variation (CoVs) of T(1)
mapping and ADC were very good at <2.9%. Intra class correlations (ICCs) were
high for cortex perfusion (0.801), cortex and medulla T(1) (0.848 and 0.997 using
SE-EPI), and renal artery flow (0.844). In response to hypercapnia, a decrease in
cortex T(2)(*) was observed, whilst no significant effect of hyperoxia on T(2)(*)
was found. In CKD patients, renal artery and vein blood flow, and renal perfusion
was lower than for healthy participants. Renal cortex and medulla T(1) was
significantly higher in CKD patients compared to healthy participants, with
corticomedullary T(1) differentiation reduced in CKD patients compared to healthy
participants. No significant difference was found in renal T(2)(*). Conclusions:
Multiparametric MRI is a powerful technique for the assessment of changes in
structure, hemodynamics, and oxygenation in a single scan session. This protocol
provides the potential to assess the pathophysiological mechanisms in various
etiologies of renal disease, and to assess the efficacy of drug treatments.