Kidney morphological parameters measured using noncontrast-enhanced steady-state free precession MRI with spatially selective inversion recovery pulse correlate with eGFR in patients with advanced CKD

• DOI: 10.1007/s10157-017-1413-x
• Publication Date: 2017-04-22T10:40:52Z
• Authors: Tadashi Otsuka; Yoshikatsu Kaneko; Yuya Sato; Ryohei Kaseda; Ryuji Aoyagi; Suguru Yamamoto; Shin Goto; Ichiei Narita
• Keywords: Adult; Aged, 80 and over; Male; Aging; Kidney Medulla; Kidney Cortex; Adolescent; Middle Aged; Kidney; Kidney Function Tests; Magnetic Resonance Imaging; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Diabetic Neuropathies; Humans; Original Article; Female; Renal Insufficiency, Chronic; Aged; Glomerular Filtration Rate

It is well known that atrophic renal changes are associated with chronic kidney disease (CKD) progression, but conventional diagnostic imaging methods such as noncontrast-enhanced computed tomography and magnetic resonance imaging (MRI) have been insufficient for precisely assessing kidney function because they cannot clearly distinguish between the medulla and cortex. Hence, here we used noncontrast-enhanced steady-state free precession (SSFP) MRI with a spatially selective inversion recovery (IR) pulse to improve visibility for renal corticomedullary differentiation and evaluated the association between morphological parameters and kidney function in patients with CKD.Kidney corticomedullary contrast ratio, cortical and medullary areas, and minimal cortical thickness of 107 patients with CKD G1-G5 were measured using SSFP MRI with a spatially selective IR pulse and the association between these morphological parameters and kidney function were evaluated.Corticomedullary contrast ratio was significantly improved on SSFP MRI compared with conventional in-phase T1-weighted gradient-echo MRI and positively correlated with estimated glomerular filtration ratio (eGFR), raw eGFR, and 24-h creatinine clearance. The medullary and cortical areas and minimal cortical thickness also positively correlated with those of kidney functional markers and the age. In patients with CKD and diabetes mellitus (DM), the correlation coefficients between raw eGFR and morphological parameters were higher than those in patients without DM, while minimal cortical thickness was larger in CKD patients with DM with a raw eGFR ≥ 45 mL/min.Kidney morphological parameters measured with SSFP MRI were clearly correlated with kidney function in patients with CKD, including those with advanced kidney dysfunction.