Jonathan R Dillman1,2, Stefanie W Benoit3,4, Deep B Gandhi5, Andrew T Trout5,6,4, Jean A Tkach5,6, Katherine VandenHeuvel4,7,8, Prasad Devarajan3,4. 1. Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45244, USA. Jonathan.Dillman@cchmc.org. 2. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Jonathan.Dillman@cchmc.org. 3. Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 4. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 5. Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45244, USA. 6. Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 7. Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 8. Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Abstract
PURPOSE: Multiparametric quantitative renal MRI may provide noninvasive radiologic biomarkers of chronic kidney disease (CKD) based on investigations in animal models and adults. We aimed to (1) obtain normative multiparametric quantitative MRI data from the kidneys of healthy children and young adults, (2) compare MRI measurements between healthy control participants and patients with CKD, and (3) determine if MRI measurements correlate with clinical and laboratory data as well as histology. METHODS: This was a prospective, case-control study of 20 healthy controls and 12 CKD patients who underwent percutaneous renal biopsy ranging from 12 to 23 years of age between October 2018 and March 2020. Kidney function was documented and pathology assessed for fibrosis/inflammation. Utilizing a field strength of 1.5T, we examined renal T1, T2, and T2* relaxation mapping, MR elastography (MRE), and diffusion-weighted imaging (DWI). A single analyst made all manual measurements for quantitative MRI pulse sequences. Independent measurements from cortex, medulla, and whole kidney were obtained by drawing regions of interest on single slices from the upper, mid, and lower kidney. A weighted average was calculated for each kidney; if two kidneys, the right and left were averaged. Continuous variables were compared with Mann-Whitney U test; bivariate relationships were assessed using Spearman rank-order correlation. RESULTS: Median estimated glomerular filtration rate (eGFR) was 112.3 ml/min/1.73 m2 in controls (n = 20, 10 females) and 55.0 ml/min/m2 in CKD patients (n = 12, 2 females) (p < 0.0001). Whole kidney (1333 vs. 1291 ms; p = 0.018) and cortical (1212 vs 1137 ms; p < 0.0001) T1 values were higher in CKD patients. Cortical T1 values correlated with eGFR (rho = - 0.62; p = 0.0003) and cystatin C (rho = 0.58; p = 0.0007). Whole kidney (1.87 vs. 2.02 10-3 mm2/s; p = 0.007), cortical (1.89 vs. 2.04 10-3 mm2/s; p = 0.008), and medullary (1.87 vs. 1.98 10-3 mm2/s; p = 0.0095) DWI apparent diffusion coefficients (ADC) were lower in CKD patients. Whole kidney ADC correlated with eGFR (rho = 0.45; p = 0.012) and cystatin C (rho = - 0.46; p = 0.009). Cortical histologic inflammation correlated with DWI ADC (rho = - 0.71; p = 0.011). CONCLUSION: Renal T1 relaxation and DWI ADC measurements differ between pediatric healthy controls and CKD patients, correlate with laboratory markers of CKD, and may have histologic correlates.
PURPOSE: Multiparametric quantitative renal MRI may provide noninvasive radiologic biomarkers of chronic kidney disease (CKD) based on investigations in animal models and adults. We aimed to (1) obtain normative multiparametric quantitative MRI data from the kidneys of healthy children and young adults, (2) compare MRI measurements between healthy control participants and patients with CKD, and (3) determine if MRI measurements correlate with clinical and laboratory data as well as histology. METHODS: This was a prospective, case-control study of 20 healthy controls and 12 CKD patients who underwent percutaneous renal biopsy ranging from 12 to 23 years of age between October 2018 and March 2020. Kidney function was documented and pathology assessed for fibrosis/inflammation. Utilizing a field strength of 1.5T, we examined renal T1, T2, and T2* relaxation mapping, MR elastography (MRE), and diffusion-weighted imaging (DWI). A single analyst made all manual measurements for quantitative MRI pulse sequences. Independent measurements from cortex, medulla, and whole kidney were obtained by drawing regions of interest on single slices from the upper, mid, and lower kidney. A weighted average was calculated for each kidney; if two kidneys, the right and left were averaged. Continuous variables were compared with Mann-Whitney U test; bivariate relationships were assessed using Spearman rank-order correlation. RESULTS: Median estimated glomerular filtration rate (eGFR) was 112.3 ml/min/1.73 m2 in controls (n = 20, 10 females) and 55.0 ml/min/m2 in CKD patients (n = 12, 2 females) (p < 0.0001). Whole kidney (1333 vs. 1291 ms; p = 0.018) and cortical (1212 vs 1137 ms; p < 0.0001) T1 values were higher in CKD patients. Cortical T1 values correlated with eGFR (rho = - 0.62; p = 0.0003) and cystatin C (rho = 0.58; p = 0.0007). Whole kidney (1.87 vs. 2.02 10-3 mm2/s; p = 0.007), cortical (1.89 vs. 2.04 10-3 mm2/s; p = 0.008), and medullary (1.87 vs. 1.98 10-3 mm2/s; p = 0.0095) DWI apparent diffusion coefficients (ADC) were lower in CKD patients. Whole kidney ADC correlated with eGFR (rho = 0.45; p = 0.012) and cystatin C (rho = - 0.46; p = 0.009). Cortical histologic inflammation correlated with DWI ADC (rho = - 0.71; p = 0.011). CONCLUSION: Renal T1 relaxation and DWI ADC measurements differ between pediatric healthy controls and CKD patients, correlate with laboratory markers of CKD, and may have histologic correlates.
Authors: Peter N Furness; Carl M Philpott; Mary T Chorbadjian; Michael L Nicholson; Jean-Louis Bosmans; Bob L Corthouts; Johannes J P M Bogers; Anke Schwarz; Wilfried Gwinner; Hermann Haller; Michael Mengel; Daniel Seron; Francesc Moreso; Conception Cañas Journal: Transplantation Date: 2003-09-27 Impact factor: 4.939
Authors: Rajiv Saran; Bruce Robinson; Kevin C Abbott; Lawrence Y C Agodoa; Jennifer Bragg-Gresham; Rajesh Balkrishnan; Nicole Bhave; Xue Dietrich; Zhechen Ding; Paul W Eggers; Abduzhappar Gaipov; Daniel Gillen; Debbie Gipson; Haoyu Gu; Paula Guro; Diana Haggerty; Yun Han; Kevin He; William Herman; Michael Heung; Richard A Hirth; Jui-Ting Hsiung; David Hutton; Aya Inoue; Steven J Jacobsen; Yan Jin; Kamyar Kalantar-Zadeh; Alissa Kapke; Carola-Ellen Kleine; Csaba P Kovesdy; William Krueter; Vivian Kurtz; Yiting Li; Sai Liu; Maria V Marroquin; Keith McCullough; Miklos Z Molnar; Zubin Modi; Maria Montez-Rath; Hamid Moradi; Hal Morgenstern; Purna Mukhopadhyay; Brahmajee Nallamothu; Danh V Nguyen; Keith C Norris; Ann M O'Hare; Yoshitsugu Obi; Christina Park; Jeffrey Pearson; Ronald Pisoni; Praveen K Potukuchi; Kaitlyn Repeck; Connie M Rhee; Douglas E Schaubel; Jillian Schrager; David T Selewski; Ruth Shamraj; Sally F Shaw; Jiaxiao M Shi; Monica Shieu; John J Sim; Melissa Soohoo; Diane Steffick; Elani Streja; Keiichi Sumida; Manjula Kurella Tamura; Anca Tilea; Megan Turf; Dongyu Wang; Wenjing Weng; Kenneth J Woodside; April Wyncott; Jie Xiang; Xin Xin; Maggie Yin; Amy S You; Xiaosong Zhang; Hui Zhou; Vahakn Shahinian Journal: Am J Kidney Dis Date: 2019-02-21 Impact factor: 8.860
Authors: J J Miranda Geelhoed; Veronica E Kleyburg-Linkers; Sonja P E Snijders; Maarten Lequin; Jeroen Nauta; Eric A P Steegers; Albert J van der Heijden; Vincent W V Jaddoe Journal: Pediatr Nephrol Date: 2009-03-12 Impact factor: 3.714