The Use of Magnetic Resonance to Evaluate Tissue Oxygenation in Renal Artery Stenosis
Open Access
- 1 April 2008
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American Society of Nephrology
- Vol. 19 (4), 780-788
- https://doi.org/10.1681/asn.2007040420
Abstract
Vascular occlusive disease poses a threat to kidney viability, but whether the events leading to injury and eventual fibrosis actually entail reduced oxygenation and regional tissue ischemia is unknown. Answering this question has been difficult because of the lack of an adequate method to assess tissue oxygenation in humans. BOLD (blood oxygen-level-dependent) magnetic resonance imaging detects changes in tissue deoxyhemoglobin during maneuvers that affect oxygen consumption, therefore this technique was used to image and analyze cortical and medullary segments of 50 kidneys in 25 subjects undergoing magnetic resonance (MR) angiography to diagnose renal artery stenosis (RAS). Magnetic rate of relaxation (R2*) positively correlates with deoxyhemoglobin levels and was therefore used as a surrogate measure of tissue oxygenation. Furosemide was administered to examine the effect of inhibiting energy-dependent electrolyte transport on tissue oxygenation in subjects with renovascular disease. In 21 kidneys with normal nephrograms, administration of furosemide led to a 20% decrease in medullary R2* (P < 0.01) and an 11.2% decrease in cortical R2*. In normal-size kidneys downstream of high-grade renal arterial stenoses, R2* was elevated at baseline, but fell after furosemide. In contrast, atrophic kidneys beyond totally occluded renal arteries demonstrated low levels of R2* that did not change after furosemide. In kidneys with multiple arteries, localized renal artery stenoses produced focal elevations of R2*, suggesting areas of deoxyhemoglobin accumulation. These results suggest that BOLD MR coupled with a method to suppress tubular oxygen consumption can be used to evaluate regional tissue oxygenation in the human kidney affected by vascular occlusive disease.Keywords
This publication has 35 references indexed in Scilit:
- Noninvasive Assessment of Early Kidney Allograft Dysfunction by Blood Oxygen Level-Dependent Magnetic Resonance ImagingTransplantation, 2006
- Evaluation of intra-renal oxygenation during water diuresis: A time-resolved study using BOLD MRIKidney International, 2006
- Blood Oxygenation Level–Dependent Magnetic Resonance Imaging of the Skeletal Muscle in Patients With Peripheral Arterial Occlusive DiseaseCirculation, 2006
- Angiotensin II Decreases the Renal MRI Blood Oxygenation Level–Dependent SignalHypertension, 2006
- Detection of acute renal ischemia in swine using blood oxygen level-dependent magnetic resonance imagingJournal of Magnetic Resonance Imaging, 2005
- Evaluation of intrarenal oxygenation by BOLD MRI at 3.0TJournal of Magnetic Resonance Imaging, 2004
- How does blood oxygen level‐dependent (BOLD) contrast correlate with oxygen partial pressure (pO2) inside tumors?Magnetic Resonance in Medicine, 2002
- Renal vein oxygen saturation in renal artery stenosisClinical Physiology and Functional Imaging, 1992
- The Effect of Saline Infusion on Sodium Reabsorption by the Proximal Tubule of the Dog*JCI Insight, 1965
- FUNCTIONAL CHARACTERISTICS OF RENOVASCULAR HYPERTENSIONMedicine, 1961