Use of Three‐Dimensional Arterial Spin Labeling to Evaluate Renal Perfusion in Patients With Chronic Kidney Disease. Issue 4 (26th March 2021)

• Record Type: Journal Article
• Authors: Lu, Fang; Yang, Jing; Yang, Shuohui; Bernd, Kuehn; Fu, Caixia; Yang, Chenyao; Xu, Huihui; Liu, Mengxiao; Zhan, Songhua; Wang, Chen; Guo, Rongfang; Wu, Yu
• Is Part Of: Journal of magnetic resonance imaging. Volume 54:Issue 4(2021)
• Page Start: 1152
• Page End: 1163
• Publication Date: 2021-03-26
• Subjects: magnetic resonance imaging -- perfusion -- arterial spin labeling -- renal blood flow -- chronic kidney disease; Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.27609
• Languages: English
• ISSNs: 1053-1807

Abstract

Abstract : Background: A noninvasive method for evaluating renal blood flow (RBF) in patients with chronic kidney disease (CKD) may have clinical value in disease staging, management, and prognostication. Purpose: To evaluate effectiveness of three‐dimensional pseudocontinuous arterial spin labeling (pCASL) and pulsed arterial spin labeling (PASL) in assessment of cortex and outer medulla (cortex/OM) RBF in CKD patients and healthy volunteers (HVs). Study Type: Prospective, in a single institution. Subjects: A total of 48 CKD patients (stage 1, 2, 3, and 4–5: N = 11, 12, 13, and 12, respectively) and 18 HVs Field Strength/Sequence: 3 T, pCASL, and PASL with a three‐dimensional hybrid gradient echo/spin echo sequence. Assessment: Quality of RBF images derived from pCASL and PASL were evaluated and RBF in cortex/OM measured. Clinical and laboratory data were recorded. Statistical Tests: Image quality differences between pCASL and PASL were evaluated with Wilcoxon signed‐rank test. For both methods, analysis of variance, followed by Fisher's LSD‐ t test, was used to determine whether RBF differed between CKD stages and HVs. Pearson correlation coefficients were calculated to assess strength of relationships between cortex/OM RBF and data from clinical and laboratory tests. Results: Image quality differences were significantly higher in pCASL than PASL in both patients and HVs (both P < 0.05). For pCASL, cortex/OM RBF of patients were significantly lower than those of HVs ( P < 0.05). Cortex/OM RBF were higher in S1 and S2 patients than those in S3 and S4–5 ( P < 0.05). For PASL, only RBF in cortex of S1 and S2 patients were significantly higher than those of S4–5 ( P < 0.05). Good correlations between pCASL RBF and estimated glomerular filtration (eGFR) were found in cortex/OM of patients (rho = 0.796 and 0.798, respectively, both P < 0.05), higher than those between PASL RBF and eGFR (rho = 0.430 and 0.374, respectively, both P < 0.05). Data Conclusion: Three‐dimensional pCASL may potentially be a noninvasive technique to assess renal perfusion in CKD patients in different stages. Level of Evidence: 1 Technical Efficacy: Stage 2