Detection of impaired renal allograft function in paediatric and young adult patients using arterial spin labelling MRI (ASL-MRI)

Tijana Radovic,Polina Pavicevic,Mirjana Cvetkovic,Ruza Stevic,Ivana Gojkovic,Brankica Spasojevic,Mirjana Kostic,Milica M Jankovic

doi:10.1038/s41598-022-04794-y

Tijana Radovic, Polina Pavicevic + Show 6 more

Open Access

https://doi.org/10.1038/s41598-022-04794-y

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Abstract

The study aimed to discriminate renal allografts with impaired function by measuring cortical renal blood flow (cRBF) using magnetic resonance imaging arterial spin labelling (ASL-MRI) in paediatric and young adult patients. We included 18 subjects and performed ASL-MRI on 1.5 T MRI to calculate cRBF on parameter maps. cRBF was correlated to calculated glomerular filtration rate (GFR) and compared between patient groups with good (GFR ≥ 60 mL/min/1.73 m2) and impaired allograft function (GFR < 60 mL/min/1.73 m2). Mean cRBF in patients with good allograft function was significantly higher than in patients with impaired allograft function (219.89 ± 57.24 mL/min/100 g vs. 146.22 ± 41.84 mL/min/100 g, p < 0.008), showing a highly significant correlation with GFR in all subjects (r = 0.75, p < 0.0001). Also, the diffusion-weighted imaging (DWI-MRI) apparent diffusion coefficient (ADC) and Doppler measurements of peak-systolic and end-diastolic velocities and the resistive index (PS, ED, RI) were performed and both methods showed no significant difference between groups. ADC implied no correlation with GFR (r = 0.198, p = 0.464), while PS indicated moderate correlation to GFR (r = 0.48, p < 0.05), and PS and ED moderate correlation to cRBF (r = 0.58, p < 0.05, r = 0.56, p < 0.05, respectively). Cortical perfusion as non-invasively measured by ASL-MRI differs between patients with good and impaired allograft function and correlates significantly with its function.

Highlights

The chief parameter which regulates renal function is its blood perfusion
The studies analysing the utility of arterial spin labelling (ASL)-MRI perfusion of renal allografts were mostly done in the adult population, and investigations including paediatric populations are greatly lacking[3,4,5,14,15,16,17,18,19,20], with a few exceptions such as one study evaluating the native kidney in paediatric patients but not allografts[21]
Intestinal peristalsis was found to be a possible source of motion artefacts, which was resolved along with other important clinical factors by organising patients to come early in the morning fasted from food and water from the night before

Summary

Introduction

The chief parameter which regulates renal function is its blood perfusion. Perfusion is defined as blood flow at the level of the tissue capillary bed and determines the delivery of nutrients and oxygen to the tissue[4]. Arterial spin labelling (ASL) MRI has been applied in various anatomical regions to estimate tissue perfusion This MRI technique uses arterial blood water as a freely diffusible natural tracer to track and quantify tissue perfusion[3,4,14,15,16]. It is considered completely safe and non-invasive, with high potential in assessing renal allograft function. The aim of this study was to analyse the impact of ASL-MRI perfusion on the functional evaluation of renal allografts in paediatric patients using a FAIR labelling scheme and 3D imaging module with background suppression

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