Parametric and quantitative analysis of MR renographic curves for assessing the functional behaviour of the kidney

Michoux, N.; Montet, X.; Pechère, A.; Ivancevic, M.K.; Martin, P.-Y.; Keller, A.; Didier, D.; Terrier, F.; Vallée, J.-P.

doi:10.1016/j.ejrad.2004.04.010

« Previous Next »European Journal of Radiology
Volume 54, Issue 1 , Pages 124-135, April 2005

Parametric and quantitative analysis of MR renographic curves for assessing the functional behaviour of the kidney

N. Michoux
- Unité d’imagerie Numérique, Département de Radiologie, Hôpital Universitaire de Genève, Rue Micheli-du-Crest 24, CH-1211 Geneva 14, Switzerland
- Corresponding author. Tel.: +41 22 3723311; fax: +41 22 3727072.
X. Montet
- Unité d’imagerie Numérique, Département de Radiologie, Hôpital Universitaire de Genève, Rue Micheli-du-Crest 24, CH-1211 Geneva 14, Switzerland
A. Pechère
- Policlinique de Médecine et Service d’Endocrinologie, Hôpital Universitaire de Genève, Rue Micheli-du-Crest 24, CH-1211 Geneva 14, Switzerland
M.K. Ivancevic
- Unité d’imagerie Numérique, Département de Radiologie, Hôpital Universitaire de Genève, Rue Micheli-du-Crest 24, CH-1211 Geneva 14, Switzerland
P.-Y. Martin
- Service de Néphrologie, Hôpital Universitaire de Genève, Rue Micheli-du-Crest 24, CH-1211 Geneva 14, Switzerland
A. Keller
- Unité d’imagerie Numérique, Département de Radiologie, Hôpital Universitaire de Genève, Rue Micheli-du-Crest 24, CH-1211 Geneva 14, Switzerland
D. Didier
- Unité d’imagerie Numérique, Département de Radiologie, Hôpital Universitaire de Genève, Rue Micheli-du-Crest 24, CH-1211 Geneva 14, Switzerland
F. Terrier
- Unité d’imagerie Numérique, Département de Radiologie, Hôpital Universitaire de Genève, Rue Micheli-du-Crest 24, CH-1211 Geneva 14, Switzerland
J.-P. Vallée
- Unité d’imagerie Numérique, Département de Radiologie, Hôpital Universitaire de Genève, Rue Micheli-du-Crest 24, CH-1211 Geneva 14, Switzerland

Received 7 January 2004; received in revised form 8 April 2004; accepted 13 April 2004.

Abstract

The aim of this study was to refine the description of the renal function based on MR images and through transit-time curve analysis on a normal population and on a population with renal failure, using the quantitative model of the up-slope. Thirty patients referred for a kidney MR exam were divided in a first population with well-functioning kidneys and in a second population with renal failure from ischaemic kidney disease. The perfusion sequence consisted of an intravenous injection of Gd-DTPA and of a fast GRE sequence T1-TFE with 90° magnetisation preparation (Intera 1.5T MR System, Philips Medical System). To convert the signal intensity into 1/T1, which is proportional to the contrast media concentration, a flow-corrected calibration procedure was used. Following segmentation of regions of interest in the cortex and medulla of the kidney and in the abdominal aorta, outflow curves were obtained and filtered to remove the high frequency fluctuations. The model of the up-slope method was then applied. Significant reduction of the cortical perfusion (Q_c=0.057±0.030ml/(s100g) to Q_c=0.030±0.017ml/(s100g), P<0.013), of the medullary perfusion (Q_m=0.023±0.018ml/(s100g) to Q_m=0.011±0.006ml/(s100g), P<0.046) and of the accumulation of contrast media in the medulla (Q_a=0.005±0.003ml/(s100g) to Q_a=0.0009±0.0008ml/(s100g), P<0.001) were found in presence of renal failure. High correlations were found between the creatinine level and the accumulation Q_a in the medulla (r²=0.72, P<0.05), and between the perfusion ratio Q_c/Q_m and the accumulation Q_a in the medulla (r²=0.81, P<0.05). No significant difference was found in times to peak between both populations despite a trend showing T_a the time to the end of the increasing contrast accumulation period in the medulla, arriving later for renal failure. Advances in MR signal calibration with the building of quantitative model such as the up-slope allow to assess kinetic and haemodynamic and functional parameters of the diseased kidney.