Tomohiko Nishino1, Kazuhiro Takahashi2, Sayaka Ono2, Masakazu Mimaki2. 1. Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. sinonosino@yahoo.co.jp. 2. Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
Abstract
PURPOSE: Noninvasive assessment of the kidney using blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) has progressed remarkably; indications have expanded to include the evaluation of glomerulonephritis. However, no longitudinal measurements from acute to post-treatment remission phases have been reported. Hence, this study aimed to investigate spin relaxation rate (R2*) values during acute and remission phases in children with glomerulonephritis. MATERIALS AND METHODS: All pediatric patients with IgA vasculitis with nephritis (IgAVN) diagnosed between January 2014 and October 2021 and requiring renal biopsy were retrospectively reviewed; four patients who were observed from onset to remission were included in this study. In total, eight MRIs were performed in the acute and remission phases, and R2* values and fluctuations induced by low-dose oxygen administration were determined from 10 echoes using a 1.5 T MRI system with 4.76-47.6 ms echo times and a 153 ms repetition time. RESULTS: The median age of patients undergoing MRI was 8.5 years in the acute phase and 13.9 years in the remission phase. R2* values of the acute phase were higher than those of the remission phase; however, the difference was not significant (cortex; p = 0.32 and medulla; p = 0.052). Oxygen administration did not cause fluctuations in the R2* values in the cortex or medulla during the acute phase (cortex; p = 0.67 and medulla; p = 0.76); however, in the remission phase, the R2* values in the cortex and medulla significantly decreased due to low-dose oxygen administration (cortex; p < 0.01 and medulla; p < 0.01). CONCLUSION: The fluctuation in R2* values observed during different phases of IgAVN indicates that BOLD MRI may be used to assess disease activity. Therefore, we propose BOLD MRI with low-dose oxygen administration as a noninvasive method to evaluate the activity of glomerulonephritis.
PURPOSE: Noninvasive assessment of the kidney using blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) has progressed remarkably; indications have expanded to include the evaluation of glomerulonephritis. However, no longitudinal measurements from acute to post-treatment remission phases have been reported. Hence, this study aimed to investigate spin relaxation rate (R2*) values during acute and remission phases in children with glomerulonephritis. MATERIALS AND METHODS: All pediatric patients with IgA vasculitis with nephritis (IgAVN) diagnosed between January 2014 and October 2021 and requiring renal biopsy were retrospectively reviewed; four patients who were observed from onset to remission were included in this study. In total, eight MRIs were performed in the acute and remission phases, and R2* values and fluctuations induced by low-dose oxygen administration were determined from 10 echoes using a 1.5 T MRI system with 4.76-47.6 ms echo times and a 153 ms repetition time. RESULTS: The median age of patients undergoing MRI was 8.5 years in the acute phase and 13.9 years in the remission phase. R2* values of the acute phase were higher than those of the remission phase; however, the difference was not significant (cortex; p = 0.32 and medulla; p = 0.052). Oxygen administration did not cause fluctuations in the R2* values in the cortex or medulla during the acute phase (cortex; p = 0.67 and medulla; p = 0.76); however, in the remission phase, the R2* values in the cortex and medulla significantly decreased due to low-dose oxygen administration (cortex; p < 0.01 and medulla; p < 0.01). CONCLUSION: The fluctuation in R2* values observed during different phases of IgAVN indicates that BOLD MRI may be used to assess disease activity. Therefore, we propose BOLD MRI with low-dose oxygen administration as a noninvasive method to evaluate the activity of glomerulonephritis.
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