Intravoxel Incoherent Motion and Diffusion-Tensor Imaging in Renal Tissue under Hydration and Furosemide Flow Challenges

被引:187
作者
Sigmund, Eric E. [1 ]
Vivier, Pierre-Hugues [1 ,4 ]
Sui, Dabang [1 ]
Lamparello, Nicole A. [3 ]
Tantillo, Kristopher [3 ]
Mikheev, Artem [1 ]
Rusinek, Henry [1 ]
Babb, James S. [2 ]
Storey, Pippa [1 ]
Lee, Vivian S. [5 ]
Chandarana, Hersh [1 ]
机构
[1] NYU, Langone Med Ctr, Dept Radiol, New York, NY 10016 USA
[2] NYU, Langone Med Ctr, Div Biostat, New York, NY 10016 USA
[3] NYU, Langone Med Ctr, Dept Med, New York, NY 10016 USA
[4] Univ Rouen, Sch Med & Pharm, Dept Radiol, Rouen, France
[5] Univ Utah, Sch Med, Dept Radiol, Salt Lake City, UT USA
关键词
ECHO-PLANAR MR; IN-VIVO; PRELIMINARY-EXPERIENCE; MONOEXPONENTIAL MODEL; GLOMERULAR-FILTRATION; INITIAL-EXPERIENCE; COLLECTING DUCT; HEPATIC-LESIONS; WEIGHTED MRI; HUMAN KIDNEY;
D O I
10.1148/radiol.12111327
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To assess the reproducibility and the distribution of intravoxel incoherent motion (IVIM) and diffusion-tensor (DT) imaging parameters in healthy renal cortex and medulla at baseline and after hydration or furosemide challenges. Materials and Methods: Using an institutional review board-approved HIPAA-compliant protocol with written informed consent, IVIM and DT imaging were performed at 3 T in 10 volunteers before and after water loading or furosemide administration. IVIM (apparent diffusion coefficient [ADC], tissue diffusivity [D-t], perfusion fraction [f(p)], pseudodiffusivity [D-p]) and DT (mean diffusivity [MD], fractional anisotropy [FA], eigenvalues [lambda(i)]) imaging parameters and urine output from serial bladder volumes were calculated. (a) Reproducibility was quantified with coefficient of variation, intraclass correlation coefficient, and Bland-Altman limits of agreement; (b) contrast and challenge response were quantified with analysis of variance; and (c) Pearson correlations were quantified with urine output. Results: Good reproducibility was found for ADC, D-t, MD, FA, and lambda(i) (average coefficient of variation, 3.7% [cortex] and 5.0% [medulla]), and moderate reproducibility was found for D-p, f(p), and f(p) . D-p (average coefficient of variation, 18.7% [cortex] and 25.9% [medulla]). Baseline cortical diffusivities significantly exceeded medullary values except D-p, for which medullary values significantly exceeded cortical values, and lambda(1), which showed no contrast. ADC, D-t, MD, and lambda(i) increased significantly for both challenges. Medullary diffusivity increases were dominated by transverse diffusion (1.72 +/- 0.09 [baseline] to 1.79 +/- 0.10 [hydration] mu m(2)/msec, P = .0059; or 1.86 +/- 0.07 [furosemide] mu m(2)/msec, P = .0094). Urine output correlated with cortical ADC with furosemide (r = 0.7, P = .034) and with medullary lambda(1) (r = 0.83, P = .0418), lambda(2) (r = 0.85, P = .0301), and MD (r = 0.82, P = .045) with hydration. Conclusion: Diffusion MR metrics are sensitive to flow changes in kidney induced by diuretic challenges. The results of this study suggest that vascular flow, tubular dilation, water reabsorption, and intratubular flow all play important roles in diffusion-weighted imaging contrast. (c) RSNA, 2012
引用
收藏
页码:758 / 769
页数:12
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