Noninvasive measurement of renal hemodynamic functions using gadolinium enhanced magnetic resonance imaging

A technique for the assessment of single kidney hemodynamic functions utilizing a novel MR pulse sequence in conjuinction with MR contrast material administration is described. Renal extraction fraction (EF) is derived by measuring the concentration of the incoming contrast agent in the renal artery and the outgoing concentration in the renal vein. The glomerular filtration rate (GFR) can then be determined by the product of EF and renal plasma flow. A modified iniversion recovery MR pulse sequence is used to measure the T1 of moving blood. This pulse sequence uses a spatially nonselective inversion pulse. A series of small flip angle detection pulses are then used to monitor the recovery of longitudinal spin magnetization in an image plane intersecting the renal vessels. The recovery rate is measured in each vessel and the T1 of blood determined. These T1 measurements are then used to determine the ratio of contrast concentration in the renal arteries and veins. Blood flow measurements can be obtained simultaneously with T1 measurements by inserting flow‐encoding magnetic field gradients into the pulse seqiuence. Preliminary results in human volunteers suggest the feasibility of noninvasively determining hemodynamic functions with magnetic resonance.

[1]  E. Potchen,et al.  Measurement of total and unilateral renal blood flow by oblique-angle velocity-encoded 2D-cine magnetic resonance angiography. , 1993, Magnetic resonance imaging.

[2]  C. Crumb,et al.  Comparison of inulin, iothalamate, and 99mTc-DTPA for measurement of glomerular filtration rate. , 1976, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[3]  P. Choyke,et al.  Hydrated clearance of gadolinium-DTPA as a measurement of glomerular filtration rate. , 1992, Kidney international.

[4]  Mitsuaki Arakawa,et al.  Magnetic Resonance Imaging the Velocity Vector Components of Fluid Flow , 1985, Magnetic resonance in medicine.

[5]  H L Kundel,et al.  Use of Gd-DTPA and fast gradient-echo and spin-echo MR imaging to demonstrate renal function in the rabbit. , 1989, Radiology.

[6]  Gustav Konrad von Schulthess Morphology and Function in MRI , 1989 .

[7]  N J Pelc,et al.  Renal artery blood flow: quantitation with phase-contrast MR imaging with and without breath holding. , 1994, Radiology.

[8]  P. Merguerian,et al.  Glomerular filtration response to acute ureteral obstruction in the dog. , 1985, The Journal of urology.

[9]  C. Donadio,et al.  Measurement of glomerular filtration rate in man using DTPA-99mTc. , 1979, Nephron.

[10]  J. Bauer,et al.  Clinical appraisal of creatinine clearance as a measurement of glomerular filtration rate. , 1982, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[11]  J A Frank,et al.  Functional MR of the kidney , 1991, Magnetic resonance in medicine.

[12]  Gustav Konrad von Schulthess,et al.  Renal Morphology and Function in Magnetic Resonance Imaging , 1989 .

[13]  J P Kriss,et al.  Limitations of creatinine as a filtration marker in glomerulopathic patients. , 1985, Kidney international.

[14]  J. Franconi,et al.  First‐pass evaluation of renal perfusion with turboflash MR imaging and superparamagnetic iron oxide particles , 1993, Journal of magnetic resonance imaging : JMRI.

[15]  S. W. Duda,et al.  Renal handling and physiologic effects of the paramagnetic contrast medium, gadolinium-DOTA. , 1990, Investigative radiology.

[16]  K. Hayakawa,et al.  A comparison of clearance and arteriovenous extraction techniques for measurements of renal hemodynamic functions. , 1986, Investigative radiology.

[17]  G. van Kaick,et al.  Renovascular hypertension: a perfusion disturbance that escaped recognition. , 1993, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.