Changes of Renal Water Diffusion Coefficient After Application of Iodinated Contrast Agents Effect of Viscosity

被引:17
作者
Jost, Gregor [1 ]
Lenhard, Diana C.
Sieber, Martin A. [2 ]
Lengsfeld, Philipp [3 ]
Huetter, Joachim
Pietsch, Hubertus
机构
[1] Bayer Pharma AG, TRG Diagnost Imaging, Cardiovasc Imaging & Contrast Media Res, D-13353 Berlin, Germany
[2] Intendis GmbH, Global Mkt, Berlin, Germany
[3] Bayer Pharma AG, Global Med Affairs Diagnost Imaging, D-13353 Berlin, Germany
关键词
contrast agent; iodixanol; iopromide; viscosity; diffusion-weighted MRI; GLOMERULAR-FILTRATION-RATE; PRELIMINARY-EXPERIENCE; MONOEXPONENTIAL MODEL; ISO-OSMOLAR; RAT-KIDNEY; MEDIA; NEPHROTOXICITY; FAILURE;
D O I
10.1097/RLI.0b013e31822b1272
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
Objective: X-ray contrast agents (CA) possess specific physicochemical properties and are excreted renally by glomerular filtration. Thereby, they may affect the diffusion of water molecules within the kidney. The aim of our preclinical study was to investigate potential changes in the apparent diffusion coefficient (ADC) of the kidney after administration of monomeric, low-osmolar, and dimeric, iso-osmolar CA by using diffusion-weighted magnetic resonance imaging (DWI). Material and Methods: First, the relationship between CA viscosity and the ADC of water was assessed by phantom measurements. Subsequently, Han Wistar rats (8 per group) received an intravenous injection of iso-osmolar CA (iodixanol) or low-osmolar CA (iopromide) at a dosage of 4 gI/kg body weight. The control group received saline (0.9% NaCl) at the same volume. The renal ADC was dynamically monitored up to 40 minutes postinjection (p.i.) by DWI using a 1.5-T clinical MR unit. After DWI, the animals were killed and the kidneys were removed for iodine measurements by x-ray fluorescence analysis. Results: The in vitro measurements yielded an inverse relationship between increasing viscosity and decreasing water diffusion. In vivo, a slight increase in ADC was observed immediately after administration of the low-osmolar iopromide (Delta ADC = 80 +/- 78 mu m(2)/s) and saline (Delta ADC = 89 +/- 53 mu m(2)/s), which normalized to the baseline level at 40 minutes p.i. In contrast, a strong decrease in ADC was observed after administration of the iso-osmolar iodixanol. This was most prominent 12 minutes p.i. (Delta ADC = -555 +/- 194 mu m(2)/s) and persisted throughout the investigation. Concomitantly, the kidney iodine concentration 50 minutes p.i. was significantly higher after iodixanol (58.6 +/- 5.3 mgI/g kidney) compared with iopromide injection (18.4 +/- 4.5 mgI/g kidney). Conclusion: A significant difference in the renal ADC was observed between the low-osmolar CA/saline and the iso-osmolar CA. The in vitro measurements suggest that the substantial decrease in ADC observed after administration of the iso-osmolar CA is based on the high viscosity of the agent during renal passage. This, in turn, may explain the delayed iodine retention after administration of iso-osmolar CA and demonstrates the importance of the physicochemical properties of CA during their renal elimination.
引用
收藏
页码:796 / 800
页数:5
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