Abstract: TH-PO506

Blood Oxygen Level Dependent Imaging of CKD in Children

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 305 CKD: Clinical Trials and Tubulointerstitial Disorders

Authors

  • Luo, Fenglan, West China Second University hospital, Sichuan University, Chengdu, China
  • Tao, Yuhong, West China Second University hospital, Sichuan University, Chengdu, China
Background

Renal chronic hypoxia plays a vital role in the development of end-stage renal disease. Blood oxygen level dependent(BOLD) imaging can assess the oxygenation of kidney. Although BOLD-MRI is used for studying chronic kidney disease(CKD) in adults, BOLD has fewer applications in children with CKD. This study aims to investigate the values of BOLD-MRI in evaluating oxygenation of kidney and renal function of CKD in children.

Methods

All of these subjects underwent studies BOLD images on 1.5T MRI scanner as follows: scanning sequence FFE, FOV=200mm×282mm×70mm, slice thickness=5mm, slice number=12, TR=400ms, voxel size=3mm×3mm, flip angle =45°, echo train length=16. R2* value of cortex and medulla were obtained. The cortical and medullary R2* value were compared between the groups. The correlation of serum creatinine level(Scr) and eGFR with R2* value was also discussed. With the ROC curve, the diagnostic effectiveness of R2* value for severity of CKD was evaluated.

Results

The images of 6 healthy volunteers and 21 minor/moderate CKD children(CKD stage1-3), 16 severe CKD children(CKD stage4-5) were finally analyzed. Both in the CKD groups and control group, the R2* value in cortex was significantly lower than that in medulla. Cortical R2* value(11.61051±0.42012) of CKD stage1-3 was significantly higher than that of control group(10.74787±0.17737). Both cortical R2* value(12.99746±1.35398) and medullary R2* value(21.13990±1.90089) of CKD stage 4-5 were significantly higher than those of CKD stage1-3. In CKD patients, negative correlations were found between cortical R2* value with Scr level(r=0.800,P<0.001), and also between medullary R2* value with Scr level(r=0.898,P<0.001). Positive correlations were found between cortical R2* value(r=-0.586,P<0.001) and medullary R2* value(r=-0.838,P<0.001) with eGFR. The area under ROC curve for cortical R2* value in differentiating between minor/moderate CKD kidneys and normal kidneys, and between minor/moderate CKD kidneys and severe CKD kidneys were 1.00 and 0.89, respectively. With the threshold from ROC curve, the sensitivity and specificity of differentiating CKD stage1-3 and controls were all 100%.

Conclusion

BOLD-MRI is valuable in diagnosis and severity of CKD in children. Renal R2* value presents the level of oxygenation of kidney and reflects the change of renal function. BOLD-MRI provides a novel technique to evaluate the severity of CKD in children.