Kidney Week

Abstract: SA-PO053

Detection of Acute Change in Renal Perfusion Using Arterial Spin Labeling MRI

Session Information

• Engineering-Based Approaches to Problems in Nephrology
  November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Bioengineering

• 300 Bioengineering

Authors

• Kannenkeril, Dennis, University Hospital Erlangen, Erlangen, Germany

Dennis Kannenkeril,

• Janka, Rolf, University Hospital Erlangen, Erlangen, Germany

Rolf Janka,

• Jung, Susanne, University Hospital Erlangen, Erlangen, Germany

Susanne Jung,

• Striepe, Kristina, University Hospital Erlangen, Erlangen, Germany

Kristina Striepe,

• Ott, Christian, University Hospital Erlangen, Erlangen, Germany

Christian Ott,

• Uder, Michael, University Hospital Erlangen, Erlangen, Germany

Michael Uder,

• Schmieder, Roland E., University Hospital Erlangen, Erlangen, Germany

Roland E. Schmieder,

Background

Magnetic resonance imaging(MRI) with arterial spin labeling(ASL) is a noninvasive promising approach to measure renal blow flow without the use of contrast dye. The purpose of this study was to evaluate change in renal perfusion following a physiological stress(Experiment 1), by ASL kidney perfusion measurements. We also compared the renal perfusion in 3 different study populations(healthy controls(C), patients with hypertension(HT) and chronic renal failure(CRF)- Experiment 2).

Methods

MRI with ASL was performed with a 1.5 Tesla MRI(Magnetom Aera, Siemens Healthineers, Erlangen, Germany) using a FAIR True-FISP sequence. Cortical, medullary, and whole kidney parenchymal perfusion were determined separately. After initial MRI measurement in C and HT, the measurement was repeated after both feet were covered with 1 degree C ice packs, which trigger a systemic sympathetic activation leading to vasoconstriction(cold pressor test).

Results

The group of C subjects(11 males, aged 35.2 ± 12 years) was compared to HT(11 males, aged 39.2 ± 10.3 years) and CRF patients(8 males, 2 females, aged 68.3 ± 7.8 years). The renal perfusion of both kidneys in HT(309.5 ± 17.3 mL/100 g/min) and CRF patients(260.4 ± 29.0 mL/100 g/min) were significantly lower compared to C subjects(338.7 ± 30.0 mL/100 g/min)(C vs. HT- age adjusted p=0.014, C vs. CRF- age- and gender adjusted p=0.004 ). Renal perfusion was also significantly different between patients with HT and patients with CRF (age- and gender-adjusted p=0.047).
In the first experiment blood pressure and heart rate increased significantly in response to the sympathetic trigger. Significant reduction in renal cortical perfusion also has been found. A trend has been noticed in the whole renal perfusion.

Conclusion

With Experiment 1, we could demonstrate that acute changes in renal blood flow could be detected using ASL-MRI. Experiment 2 documented that this technology is able to detect differences in renal perfusion between heathy subjects and diseased subjects by needing only few subjects per group. This offers an advantage in conducting clinical trials in humans compared to other technologies.