Dynamic Contrast Bolus Computed Tomography for the Assessment of Renal Function

Dawson, Peter; Peters, Michael

doi:10.1097/00004424-199311000-00014

Cited by 54 publications

(35 citation statements)

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“…The first three patients studied were all women aged 55-61 years with malignancies, but normal biochemistry. Excellent linear fits were obtained, with fractional vascular volume values of 28-31% and values for a/V of 0.35-0.44 min" 1[24,25]. Dawson has gone on to study a further six similar patients, again with excellent linear fits and cc/V values of around 0.40 andfvv values of about 30%(Dawson, unpublished data).These values compare well with expectations.…”

supporting

confidence: 62%

“…Using single level data acquisition with a conventional Siemens Somatom Plus scanner (Siemens AG, Erlangen, Germany), Dawson and Peters scanned at 5 s intervals for 2 min after a 40 ml bolus of non-ionic perfiuoroctylbromide [26] and the figure of 23 ml per 100 g of cortex found by Cohn et al using indocyanine green [27]. Finally, the values obtained can be used to estimate renal transit time, with values again close to expectation [24]. Is the technique of any clinical value?…”

Section: Early Phase Analysis: the Patlak Plotmentioning

confidence: 81%

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The quantification of renal function with enhanced computed tomography

Blomley¹,

Dawson²

1996

The British Journal of Radiology

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The changes with time in renal parenchymal and vascular attenuation following injection of an intravascular contrast medium can be exploited to study renal physiology in several ways. Shortly after injection, both contrast medium clearance and fractional vascular volume per unit volume of kidney can be measured on a regional basis by obtaining sequential CT data from one anatomical level and the application of a graphical analysis to the baseline subtracted CT numbers for tissue and vascular regions of interest: c(t) and b(t), respectively. By plotting the ratio c(t)/b(t) against integral of b(t)dt/b(t), both fractional vascular volume and contrast medium clearance can be estimated graphically. At later time points, a semilogarithmic plot against time of the declining attenuation of vascular or parenchymal regions of interest gives information about overall, as opposed to regional, renal function: the gradient estimates the glomerular filtration rate per unit volume of extracellular fluid. Absolute glomerular filtration rates can also be calculated with blood sampling. Although further experimental evaluation is needed, these techniques have a strong theoretical basis, and experimental work performed so far is encouraging. Possible applications of these techniques are discussed.

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supporting

confidence: 62%

Section: Early Phase Analysis: the Patlak Plotmentioning

confidence: 81%

The quantification of renal function with enhanced computed tomography

Blomley¹,

Dawson²

1996

The British Journal of Radiology

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“…Consequently, DCE-CT using an iodinated CA has been applied to the measurement of GFR. 8,10,11 The purpose of this study was to investigate experimentally the age-dependent differences of cisplatin-induced nephrotoxicity in rats using DCE-CT.…”

Section: Introductionmentioning

confidence: 99%

Experimental verification of age-dependent cisplatin-induced nephrotoxicity in rats using dynamic contrast-enhanced computed tomography

et al. 2010

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“…The incidence of CIN is increased in patients already predisposed to renal insufficiency [4, 5]. Two mechanisms have been found to be primarily responsible for CIN development: contrast media (CM)-triggered vasoconstriction and development of oxidative stress, i.e.…”

Section: Introductionmentioning

confidence: 99%

“…It has been demonstrated that following CM application the renal outer medullar blood flow is reduced, resulting in medullar ischemia [6]. Hypovolemic patients are, therefore, at increased risk for developing CIN, due to the initially low renal perfusion rate [4, 5]. At the cellular level, CM agents have been demonstrated to trigger excessive generation of ROS, thus amplifying intrarenal oxidative stress and exerting direct toxic effects on renal tubular tissue [7,8,9,10].…”

Section: Introductionmentioning

confidence: 99%

Differential Effects of N-Acetylcysteine, Theophylline or Bicarbonate on Contrast-Induced Rat Renal Vasoconstriction

et al. 2008

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Background: Vasoconstriction and reactive oxygen species (ROS) accumulation following contrast media (CM) injection are the key factors triggering CM-induced nephropathy. We compared the effects of N-acetylcysteine (NAC), theophylline or sodium bicarbonate on intrarenal vasoconstriction and ROS generation in a rat model of CM-induced nephropathy. Methods: Following a 3-day dehydration, Sprague-Dawley rats received CM (Telebrix) or sham ‘CM’ injection of 0.9% saline. Part of them received NAC, theophylline or bicarbonate prior to CM. Medullar renal blood flow was estimated by laser Doppler. The animals were sacrificed 1, 15 or 30 min after the respective treatments, their kidneys allocated and intrarenal STAT-8 isoprostane, PGE₂ and NO assessed. Results: Vasoconstriction was significantly attenuated by NAC. Theophylline only mildly attenuated the perfusion drop at 15 min, and was ineffective following 30 min. Unlike theophylline or bicarbonate, NAC significantly augmented intrarenal PGE₂. NAC, theophylline but not bicarbonate, gradually increased intrarenal NO. In all experimental variables, CM-induced ROS accumulation, represented by STAT-8 isoprostane estimation, progressed undisturbed. Conclusions: (1) CM-induced intrarenal vasoconstriction was efficiently prohibited by NAC but not bicarbonate or theophylline; (2) the vasodilatory effect of NAC was mediated via increased PGE₂ synthesis, and (3) ROS accumulation was a primary renal response to CM-induced injury, not affected by any pharmacologic manipulations.

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Dynamic Contrast Bolus Computed Tomography for the Assessment of Renal Function

Cited by 54 publications

References 0 publications

The quantification of renal function with enhanced computed tomography

The quantification of renal function with enhanced computed tomography

Experimental verification of age-dependent cisplatin-induced nephrotoxicity in rats using dynamic contrast-enhanced computed tomography

Differential Effects of N-Acetylcysteine, Theophylline or Bicarbonate on Contrast-Induced Rat Renal Vasoconstriction

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