Arterial spin labeling MRI is able to detect early hemodynamic changes in diabetic nephropathy

Mora-Gutiérrez, José María; García-Fernández, Núria; Roblero, María Fernanda Slon; Páramo, José A.; Escalada, Javier; Wang, Danny J.J.; Benito, Alberto; Fernández‐Seara, María A.

doi:10.1002/jmri.25717

Cited by 81 publications

(89 citation statements)

References 38 publications

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“…This is in good agreement with a recent report that evaluated ASL perfusion MRI in diabetic nephropathy [21]. It is also consistent with the report by Khatir et al [39] on renal artery blood flow using phase contrast MRI.…”

Section: Discussionsupporting

confidence: 82%

Cortical Perfusion and Tubular Function as Evaluated by Magnetic Resonance Imaging Correlates with Annual Loss in Renal Function in Moderate Chronic Kidney Disease

Prasad

Thacker

et al. 2019

Am J Nephrol

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Background: Chronic hypoxia is a well-recognized factor in the pathogenesis of chronic kidney disease (CKD). Loss of microcirculation is thought to lead to enhanced renal hypoxia, which in turn results in the development of fibrosis, a hallmark of progressive CKD. To evaluate the role of functional magnetic resonance imaging (MRI), we performed perfusion, oxygenation, and diffusion MRI measurements in individuals with diabetes and stage 3 CKD. Methods: Fifty-four subjects (41 individuals with diabetes and stage 3 CKD and 13 healthy controls) participated in this study. Data with blood oxygenation level dependent (BOLD), arterial spin labeling perfusion and diffusion MRI were acquired using a 3T scanner. Results: Renal cortical perfusion was reduced in CKD compared to the controls (109.54 ± 25.38 vs. 203.17 ± 27.47 mL/min/100 g; p < 0.001). Cortical apparent diffusion coefficient showed no significant reduction in CKD compared to controls (1,596.10 ± 196.64 vs. 1,668.72 ± 77.29 × 10^–6 mm²/s; p = 0.45) but was significantly associated with perfusion. Cortical R2* values were modestly increased in CKD (20.76 ± 4.08 vs. 18.74 ± 2.37 s^–1; p = 0.12). Within the CKD group, R2*_Medulla and R2*_Kidney were moderately and negatively associated with estimated glomerular filtration rate. There was a significant association between cortical perfusion and medullary response to furosemide with annual loss of renal function, used as an estimate of CKD progression. Conclusions: Subjects with a moderate degree of CKD had significantly lower renal perfusion. Diffusion and BOLD MRI showed more modest differences between the groups. Individuals with progressive CKD had lower perfusion and response to furosemide.

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Section: Discussionsupporting

confidence: 82%

Cortical Perfusion and Tubular Function as Evaluated by Magnetic Resonance Imaging Correlates with Annual Loss in Renal Function in Moderate Chronic Kidney Disease

Prasad

Thacker

et al. 2019

Am J Nephrol

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“…Whether this BS is acceptable in the presence of the expected higher motion and variability in clinical applications remains to be seen. Prior studies successfully performing renal ASL without BS have typically used a FAIR labeling, which inherently provides a moderate level of background suppression because of the inversion applied to the imaged volume as part of labeling. Moreover, our study uses a fully relaxed SSFSE sequence without any fat–fluid suppression compared to fat‐suppressed EPI readouts commonly used that limit the overwhelming bright signal from peri‐renal fat.…”

Section: Discussionmentioning

confidence: 99%

“…By using an endogenous tracer, it can be repeated at will even in patients for whom contrast agents are contra‐indicated because of poor kidney function. Over the past few years, multiple reports of ASL applications for pathologies such as chronic kidney disease, renal transplant, and renal cancer have been published, further reinforcing the clinical relevance of non‐contrast imaging of kidney perfusion. Among ASL techniques, pseudo‐continuous ASL (pCASL) usually provides significant advantages over more widely used pulsed labeling methods such as the flow‐sensitive alternating inversion recovery method (FAIR), including increased SNR and better definition of the labeling bolus.…”

Section: Introductionmentioning

confidence: 95%

Influence of background suppression and retrospective realignment on free‐breathing renal perfusion measurement using pseudo‐continuous ASL

Taso

Guidon²,

Alsop

2018

Magnetic Resonance in Med

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Purpose To assess the influence of background suppression and retrospective realignment on physiological noise and image quality in free‐breathing renal pseudo‐continuous arterial spin labeling (pCASL). Methods Ten subjects were scanned at 3T with a pCASL prepared single‐slice coronal acquisition through the kidneys under free breathing. Multiple acquisitions were performed with various levels of residual background signal based on optimization of pulse timings to achieve specific background suppression levels (<2%, <5%, <10%, <20%). A retrospective non‐rigid motion‐correction strategy was also implemented. Results Decreasing level of residual background signal was associated with higher temporal SNR. The retrospective motion‐correction provided an additional but not statistically significant improvement in tSNR. The highest image quality was obtained with the lowest level of residual background signal accompanied by the retrospective motion‐correction, although no significant difference in quantitative renal blood‐flow could be observed. Conclusions Renal perfusion measurement with ASL under free breathing is feasible and robust against physiological noise when using strong background suppression strategies. Finally, retrospective motion‐correction further improves image quality but cannot replace background suppression.

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“…A decreased RBF in ASL is also observed in conjunction with the development of DN. In patients in the very early stage of DN who do not show overt clinical symptoms (eg, albuminuria), ASL is capable of achieving early detection of DN . Moreover, ADC values in DWI have a similar effect.…”

Section: Applications Of Renal Fmrimentioning

confidence: 99%

Renal Functional MRI and Its Application

Zhou

Wang

Zeng

et al. 2018

Magnetic Resonance Imaging

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Arterial spin labeling MRI is able to detect early hemodynamic changes in diabetic nephropathy

Abstract: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1810-1817.

Cited by 81 publications

References 38 publications

Cortical Perfusion and Tubular Function as Evaluated by Magnetic Resonance Imaging Correlates with Annual Loss in Renal Function in Moderate Chronic Kidney Disease

Cortical Perfusion and Tubular Function as Evaluated by Magnetic Resonance Imaging Correlates with Annual Loss in Renal Function in Moderate Chronic Kidney Disease

Influence of background suppression and retrospective realignment on free‐breathing renal perfusion measurement using pseudo‐continuous ASL

Renal Functional MRI and Its Application

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