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• W2318264954 abstract "Introduction: Acute kidney injury (AKI) is a common clinical problem caused by ischemia-reperfusion injury (IRI). Renal perfusion (RP) in AKI decreases as a consequence of vascular damages and interstitial edema, resulting in functional deterioration of the kidney. Assessment of RP in the early stage of AKI is therefore warranted. Although dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can be used to measure RP, contrast agents (CA) may also have adverse effects on the kidney and should preferably not be used in patients with impaired renal function (RF). To overcome this problem we used arterial spin labeling (ASL), a noninvasive measurement in MRI using the arterial blood as an endogenous tracer, as an innovative method for evaluating RP. Methods: We used a standardized warm ischemia model in four male Lewis rats (260g - 290g) with a 45min ischemia time. IRI was induced by clamping the left kidney vessels. To evaluate RP, ASL measurements were performed on a 3 Tesla MR scanner four days after ischemia. Because this method uses magnetically labeled protons in arterial blood, no other procedures during measurements were performed. To quantitate RP, ASL perfusion maps were calculated with an in-house MATLAB script (The MathWorks, Natick, MA, USA). After ASL measurements, we used DCE-MRI as a control to confirm our results. Thereafter, kidneys were processed for histology to evaluate cellular injury. The native right kidney served as non-ischemic damaged control. Results:Fig. 1 shows the comparison between DCE-MRI and ASL. Although both methods give crucial information about RP, ASL is a completely noninvasive measurement to use in case of injured kidneys. According to the perfusion map (Fig. 1), it is easily shown that RP of the diseased kidney (arrow) is worse than the native kidney. We evaluated a mean cortical perfusion of 277± 20ml/100g/min in the diseased kidney compared to 482± 54ml/100g/min in the native kidney. The medullary perfusion was also lower in the diseased kidney in contrast to the native kidney (58±2ml/100g/min vs. 150±30ml/100g/min).[Fig. 1: Images DCE-MRI and ASL]Moreover, on histological slides we could clearly determine that the kidneys with reduced RP are obviously damaged showing cellular swelling, tubular dilatation and necrosis that are main histological hallmarks of AKI. Conclusion: We demonstrate that ASL is able to assess RP showing changes between diseased and healthy kidneys. Histology was concordant to a reduced RP showing severe ischemic damages. Since in ASL there is no need using exogenous CA that may have adverse effects on RF, this method might be safely used particularly in patients with impaired RF or in renal transplant recipients in which immediate RF is not observed." @default.
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• W2318264954 date "2012-11-01" @default.
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• W2318264954 title "Arterial Spin Labeling: A Noninvasive Method to Assess Renal Perfusion after Ischemia-Reperfusion Injury" @default.
• W2318264954 doi "https://doi.org/10.1097/00007890-201211271-02255" @default.
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