Measurement of kidney perfusion by magnetic resonance imaging: comparison of MRI with arterial spin labeling to para-aminohippuric acid plasma clearance in male subjects with metabolic syndrome

Nephrol Dial Transplant. 2010 Apr;25(4):1126-33. doi: 10.1093/ndt/gfp639. Epub 2009 Nov 24.

Abstract

Background: Magnetic resonance imaging with arterial spin labeling (MRI-ASL) is a non-invasive approach to measure organ perfusion. We aimed to examine whether MRI-ASL kidney perfusion measurements are related to measurements of renal plasma flow (RPF) by para-aminohippuric acid (PAH) plasma clearance and whether changes of kidney perfusion in response to treatment with telmisartan can be detected by MRI-ASL.

Methods: Twenty-four patients with metabolic syndrome and an estimated creatinine clearance according to Cockroft and Gault of > or =60 ml/min were included in the study. Kidney perfusion was assessed by MRI-ASL measurements of a single coronal kidney slice (with flow-sensitive alternating inversion recovery and true fast imaging with steady-state processing sequence) and by measurements of RPF using PAH plasma clearance before and after 2 weeks of treatment with the angiotensin receptor blocker telmisartan. All MRI-ASL examinations were performed on a 1.5 T scanner.

Results: Two weeks of therapy with telmisartan led to a significant increase of RPF (from 313 +/- 47 to 348 +/- 69 ml/min/m, P = 0.007) and MRI-ASL kidney perfusion measurements (from 253 +/- 20 to 268 +/- 25 ml/min/100 g, P = 0.020). RPF measurements were related with MRI-ASL kidney perfusion measurements (r = 0.575, P < 0.001). Changes of RPF measurements and changes of MRI-ASL kidney perfusion measurements in response to treatment with telmisartan revealed a close relationship when expressed in absolute terms (r = 0.548, P = 0.015) and in percentage changes (r = 0.514, P = 0.025).

Conclusions: Perfusion measurement of a single coronal kidney slice by MRI-ASL is able to approximate kidney perfusion and to approximate changes in kidney perfusion due to pharmacological intervention.

MeSH terms

  • Adult
  • Aged
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Arteries / drug effects
  • Benzimidazoles / therapeutic use
  • Benzoates / therapeutic use
  • Blood Pressure / drug effects
  • Creatinine / metabolism
  • Hemodynamics
  • Humans
  • Kidney / blood supply*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Metabolic Syndrome / physiopathology*
  • Middle Aged
  • Renal Circulation*
  • Renal Plasma Flow / drug effects
  • Spin Labels*
  • Telmisartan
  • Young Adult
  • p-Aminohippuric Acid / blood*

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Benzimidazoles
  • Benzoates
  • Spin Labels
  • Creatinine
  • Telmisartan
  • p-Aminohippuric Acid