Literature DB >> 19539502

Quantitative MR measures of intrarenal perfusion in the assessment of transplanted kidneys: initial experience.

Andrew L Wentland1, Elizabeth A Sadowski, Arjang Djamali, Thomas M Grist, Bryan N Becker, Sean B Fain.   

Abstract

RATIONALE AND
OBJECTIVES: The purpose of this study was to evaluate prospectively a gadolinium-based perfusion technique for intrarenal blood flow in transplanted kidneys and to determine if magnetic resonance imaging (MRI) measurements of intrarenal perfusion could be used to differentiate between normal-functioning kidney allografts and allografts with acute tubular necrosis (ATN) or acute rejection.
MATERIALS AND METHODS: Twenty-one subjects were enrolled within 4 months of receiving a kidney transplant. A biopsy was performed on subjects to diagnose each allograft as having either ATN or acute rejection. A group of subjects with normal functioning transplants was also enrolled in our study. MRI perfusion images were acquired on a 1.5 T MRI system within 48 hours after biopsy using an echo planar, T2*-weighted sequence, and an injection of gadodiamide contrast agent administered at a dose of 0.1 mmol/kg. Scan parameters were: repetition time/echo time/flip = 1000 ms/30 ms/60 degrees , field of view = 340 x 340 mm, matrix = 128 x 64, slice thickness = 10 mm, and temporal resolution = 1.0 seconds. Cortical and medullary blood flow values were calculated.
RESULTS: Medullary blood flow values were significantly (P = .02) lower in allografts undergoing acute rejection (121 +/- 41 mL/100 g/min) compared to normal-functioning allografts (221 +/- 96 mL/100 g/min) and those with ATN (247 +/- 124 mL/100 g/min). Cortical blood flow values were also significantly (P = .03) reduced in allografts with acute rejection (243 +/- 116 mL/100 g/min) compared to those with normal function (413 +/- 116 mL/100 g/min).
CONCLUSIONS: Preliminary results indicate that MRI perfusion techniques may provide a means of determining noninvasively the viability of renal allografts, potentially alleviating the need for biopsy in some patients.

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Year:  2009        PMID: 19539502      PMCID: PMC2749559          DOI: 10.1016/j.acra.2009.03.020

Source DB:  PubMed          Journal:  Acad Radiol        ISSN: 1076-6332            Impact factor:   3.173


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