Functional sodium magnetic resonance imaging of the intact rat kidney.

BACKGROUND: Renal fluid homeostasis depends to a large extent on the sodium concentration gradient along the corticomedullary axis. The spatial distribution and extent of this gradient were previously determined by invasive methods, which yielded a range of results. We demonstrate here the capacity of sodium magnetic resonance imaging (MRI) to quantify non-invasively renal sodium distribution in the intact kidney.
METHODS: Sodium MRI was applied to study normal, diuretic, and obstructed rat kidneys in vivo. The images were recorded at 4.7 Tesla using a 3-dimensional gradient echo sequence, with high spatial and temporal resolution. The tissue sodium concentration (TSC) was obtained by taking into account the measured nuclear relaxation rates and MRI visibility relative to a reference saline solution.
RESULTS: The corticomedullary sodium gradient increased linearly from the cortex to the inner medulla by approximately 31 mmol/L/mm, from a TSC of approximately 60 mmol/L to approximately 360 mmol/L. Furosemide induced a 50% reduction in the inner-medulla sodium and a 25% increase in the cortical sodium. The kinetics of these changes was related to the specific site and mechanism of the loop diuretic. Distinct profiles of the sodium gradient were observed in acute obstructed kidneys, as well as spontaneously obstructed kidneys. The changes in the sodium gradient correlated with the extent of damage and the residual function of the kidneys.
CONCLUSION: Quantitative assessment of the renal corticomedullary sodium gradient by high resolution sodium MRI may help verify new aspects of the kidney concentrating mechanism and serve as a non-invasive diagnostic method of renal function.