Feasibility of measuring renal blood flow by phase-contrast magnetic resonance imaging in patients with autosomal dominant polycystic kidney disease

• Published in: European radiology Vol. 26; no. 3; pp. 683 - 692
• Main Authors: Spithoven, E. M., Meijer, E., Borns, C., Boertien, W. E., Gaillard, C. A. J. M., Kappert, P., Greuter, M. J. W., van der Jagt, E., Vart, P., de Jong, P. E., Gansevoort, R. T.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-03-2016; Springer Nature B.V
• Subjects: Adult; Blood Pressure - physiology; Cohort Studies; Contrast Media; Creatinine; Diagnostic Radiology; Disease Progression; Feasibility Studies; Female; Glomerular Filtration Rate - physiology; Hemodynamics; Hemodynamics - physiology; Humans; Imaging; Internal Medicine; Interventional Radiology; Iodine Radioisotopes; Iodohippuric Acid; Kidney diseases; Magnetic Resonance; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Patients; Phantoms, Imaging; Polycystic Kidney, Autosomal Dominant - physiopathology; Radiology; Radiopharmaceuticals; Renal Artery - physiology; Renal Circulation - physiology; Reproducibility of Results; Ultrasound; Veins & arteries; Netherlands; Phantom; Hippuran; ADPKD; Renal blood flow measurement; Phase-contrast MRI
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-015-3877-y

Objectives
Renal blood flow (RBF) has been shown to predict disease progression in autosomal dominant polycystic kidney disease (ADPKD). We investigated the feasibility and accuracy of phase-contrast RBF by MRI (RBF
MRI
) in ADPKD patients with a wide range of estimated glomerular filtration rate (eGFR) values.
Methods
First, we validated RBF
MRI
measurement using phantoms simulating renal artery hemodynamics. Thereafter, we investigated in a test-set of 21 patients intra- and inter-observer coefficient of variation of RBF
MRI
. After validation, we measured RBF
MRI
in a cohort of 91 patients and compared the variability explained by characteristics indicative for disease severity for RBF
MRI
and RBF measured by continuous hippuran infusion.
Results
The correlation in flow measurement using phantoms by phase-contrast MRI was high and fluid collection was high (CCC=0.969). Technical problems that precluded RBF
MRI
measurement occurred predominantly in patients with a lower eGFR (34% vs. 16%). In subjects with higher eGFRs, variability in RBF explained by disease characteristics was similar for RBF
MRI
compared to RBF
Hip,
whereas in subjects with lower eGFRs, this was significantly less for RBF
MRI
.
Conclusions
Our study shows that RBF can be measured accurately in ADPKD patients by phase-contrast, but this technique may be less feasible in subjects with a lower eGFR.
Key points
•
Renal blood flow (RBF) can be accurately measured by phase-contrast MRI in ADPKD patients
.
•
RBF measured by phase-contrast is associated with ADPKD disease severity
.
•
RBF measurement by phase-contrast MRI may be less feasible in patients with an impaired eGFR
.