Perfusion MR imaging with FAIR true FISP spin labeling in patients with and without renal artery stenosis: initial experience.

The purpose of this study was to prospectively evaluate an arterial spin-labeling technique, flow-sensitive alternating inversion-recovery (FAIR) true fast imaging with steady-state precession (FISP), for noninvasive quantification of renal perfusion in patients without a history of renal artery stenosis (RAS) and in patients with proved RAS. The study was approved by the local ethics committee, and all participants provided written informed consent. Six patients with hypertension but no history of renal artery disease and 12 patients with RAS underwent FAIR true FISP magnetic resonance (MR) imaging in a whole-body 1.5-T unit. RAS grade and scintigraphic perfusion data served as the reference standards. On the FAIR true FISP perfusion images, severe RAS (>70% luminal narrowing) could be clearly distinguished from no or mild RAS and moderate RAS (< or =70% luminal narrowing) (P < .005). Significant correlations between FAIR perfusion data and stenosis grade (r = -0.76) and between FAIR and single photon emission computed tomographic perfusion values (r = 0.83) were observed. FAIR true FISP was found to be suitable for quantitative perfusion imaging of the kidneys in patients with RAS.

[1]  T. L. Davis,et al.  Mr perfusion studies with t1‐weighted echo planar imaging , 1995, Magnetic resonance in medicine.

[2]  R. Dolan,et al.  First-pass renal perfusion imaging using MS-325, an albumin-targeted MRI contrast agent. , 1999, Investigative radiology.

[3]  G. Pell,et al.  Pulsed arterial spin labeling using TurboFLASH with suppression of intravascular signal , 2003, Magnetic resonance in medicine.

[4]  F. S. Pereles,et al.  Safety of gadolinium contrast angiography in patients with chronic renal insufficiency. , 2003, Journal of vascular surgery.

[5]  T. Nägele,et al.  Gd-enhanced 3D phase-contrast MR angiography and dynamic perfusion imaging in the diagnosis of renal artery stenosis. , 1998, Magnetic resonance imaging.

[6]  A Haase,et al.  Quantitative magnetic resonance imaging of perfusion using magnetic labeling of water proton spins within the detection slice , 1996, Magnetic resonance in medicine.

[7]  C. Wilcox,et al.  Newer tests for the diagnosis of renovascular disease. , 1992, JAMA.

[8]  Antonio Colombo,et al.  Contrast agent--associated nephrotoxicity. , 2003, Progress in cardiovascular diseases.

[9]  D. Farlow,et al.  Can quantitative renography predict the outcome of treatment of atherosclerotic renal artery stenosis? , 1989, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[10]  H. Haimovici,et al.  Experimental renal-artery stenosis diagnostic significance of arterial hemodynamics. , 1962, The Journal of cardiovascular surgery.

[11]  Seong-Gi Kim.  Quantification of relative cerebral blood flow change by flow‐sensitive alternating inversion recovery (FAIR) technique: Application to functional mapping , 1995, Magnetic resonance in medicine.

[12]  S. Williams,et al.  A Model for Quantification of Perfusion in Pulsed Labelling Techniques , 1996, NMR in biomedicine.

[13]  R. Semelka,et al.  Renal lesions: controlled comparison between CT and 1.5-T MR imaging with nonenhanced and gadolinium-enhanced fat-suppressed spin-echo and breath-hold FLASH techniques. , 1992, Radiology.

[14]  U. Klose,et al.  FAIR true‐FISP perfusion imaging of the kidneys , 2004, Magnetic resonance in medicine.

[15]  S J Riederer,et al.  The importance of phase‐encoding order in ultra‐short TR snapshot MR imaging , 1990, Magnetic resonance in medicine.

[16]  Hellmut Merkle,et al.  Quantitative measurements of cerebral blood flow in rats using the FAIR technique: Correlation with previous lodoantipyrine autoradiographic studies , 1998, Magnetic resonance in medicine.

[17]  B. Siewert,et al.  STAR‐HASTE: Perfusion imaging without magnetic susceptibility artifact , 1997, Magnetic resonance in medicine.

[18]  A. Nobre,et al.  Qualitative mapping of cerebral blood flow and functional localization with echo-planar MR imaging and signal targeting with alternating radio frequency. , 1994, Radiology.

[19]  A. Bjørnerud,et al.  Assessment of T1 and T  *2 effects in vivo and ex vivo using iron oxide nanoparticles in steady state—dependence on blood volume and water exchange , 2002, Magnetic resonance in medicine.

[20]  N. Rofsky,et al.  MR imaging relaxation times of abdominal and pelvic tissues measured in vivo at 3.0 T: preliminary results. , 2004, Radiology.

[21]  J Graeme Houston,et al.  Dynamic MRI contrast enhancement of renal cortex: A functional assessment of renovascular disease in patients with renal artery stenosis , 2003, Journal of magnetic resonance imaging : JMRI.

[22]  K. Hendrich,et al.  Perfusion quantitation in transplanted rat kidney by MRI with arterial spin labeling. , 1998, Kidney international.

[23]  A. Alavi,et al.  Induced renal artery stenosis in rabbits: magnetic resonance imaging, angiography, and radionuclide determination of blood volume and blood flow. , 1988, Magnetic Resonance Imaging.

[24]  J. Christopher,et al.  Perfusion of the kidney using extraslice spin tagging (eST) magnetic resonance imaging , 1999, Journal of magnetic resonance imaging : JMRI.

[25]  R R Price,et al.  Renal artery stenosis: in vivo perfusion MR imaging. , 1991, Radiology.

[26]  H. Atkins,et al.  Quantitative Evaluation of Renal Excretion on the Dynamic DTP A Renal Scan , 1989, Clinical nuclear medicine.

[27]  R E Lenkinski,et al.  Renal perfusion in humans: MR imaging with spin tagging of arterial water. , 1995, Radiology.

[28]  J. Biederer,et al.  Quantitation of renal perfusion using arterial spin labeling with FAIR-UFLARE. , 2000, Magnetic resonance imaging.