Functional multiparametric magnetic resonance imaging of the kidneys using blood oxygen level dependent and diffusion-weighted sequences

Gianluca Giannarini; Thomas M Kessler; Beat Roth; Peter Vermathen; Harriet C Thoeny

doi:10.1016/j.juro.2014.02.048

Functional multiparametric magnetic resonance imaging of the kidneys using blood oxygen level dependent and diffusion-weighted sequences

J Urol. 2014 Aug;192(2):434-9. doi: 10.1016/j.juro.2014.02.048. Epub 2014 Feb 25.

Authors

Gianluca Giannarini¹, Thomas M Kessler², Beat Roth¹, Peter Vermathen³, Harriet C Thoeny⁴

Affiliations

¹ Department of Urology, University of Bern, Inselspital, Bern, Switzerland.
² Neuro-Urology, Spinal Cord Injury Centre and Research, University of Zurich, Balgrist University Hospital, Zurich, Switzerland.
³ Department of Radiology, Neuroradiology and Nuclear Medicine, Institute of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Inselspital, Bern, Switzerland.
⁴ Department of Radiology, Neuroradiology and Nuclear Medicine, Institute of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Inselspital, Bern, Switzerland. Electronic address: harriet.thoeny@insel.ch.

PMID: 24582541
DOI: 10.1016/j.juro.2014.02.048

Abstract

Purpose: Little data are available on noninvasive magnetic resonance imaging based assessment of renal function during upper urinary tract obstruction. We determined whether functional multiparametric kidney magnetic resonance imaging could monitor the treatment response in cases of acute unilateral upper urinary tract obstruction.

Material and methods: Between January 2008 and January 2010, 18 patients with acute unilateral upper urinary tract obstruction due to calculi were prospectively enrolled to undergo kidney magnetic resonance imaging with conventional, blood oxygen level dependent and diffusion-weighted sequences upon emergency hospital admission and after release of obstruction. We assessed functional imaging parameters of obstructed and contralateral unobstructed kidneys derived from blood oxygen level dependent (apparent spin relaxation rate) and diffusion-weighted (total apparent diffusion coefficient, pure diffusion coefficient and perfusion fraction) sequences during acute upper urinary tract obstruction and after its release.

Results: During acute obstruction the apparent spin relaxation rate and perfusion fraction were lower in the cortex (p=0.020 and 0.031) and medulla (p=0.012 and 0.190, respectively) of obstructed kidneys compared to contralateral unobstructed kidneys. After obstruction release the apparent spin relaxation rate and perfusion fraction increased in the cortex (p=0.016 and 0.004) and medulla (p=0.071 and 0.044, respectively) of formerly obstructed kidneys to values similar to those in contralateral kidneys. Total apparent diffusion coefficient and pure diffusion coefficient values did not significantly differ between obstructed and contralateral unobstructed kidneys during or after obstruction.

Conclusions: In our patients with acute unilateral upper urinary tract obstruction due to calculi functional kidney magnetic resonance imaging using blood oxygen level dependent and diffusion-weighted sequences enabled us to monitor pathophysiological changes in obstructed kidneys during obstruction and after its release.

Keywords: diffusion magnetic resonance imaging; kidney; magnetic resonance imaging; ureteral obstruction; urinary calculi.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Diffusion Magnetic Resonance Imaging*
Female
Humans
Kidney / physiopathology*
Male
Middle Aged
Oxygen / blood*
Prospective Studies
Ureteral Obstruction / etiology
Ureteral Obstruction / physiopathology*
Ureteral Obstruction / therapy
Urinary Calculi / complications
Urinary Calculi / physiopathology

Substances

Oxygen