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Comparative Study
. 2014 Jan 31:15:23.
doi: 10.1186/1471-2369-15-23.

Inter-study reproducibility of arterial spin labelling magnetic resonance imaging for measurement of renal perfusion in healthy volunteers at 3 Tesla

Keith A Gillis, Christie McComb, John E Foster, Alison H M Taylor, Rajan K Patel, Scott T W Morris, Alan G Jardine, Markus P Schneider, Giles H Roditi, Christian Delles, Patrick B Mark  1
Affiliations
Comparative Study

Inter-study reproducibility of arterial spin labelling magnetic resonance imaging for measurement of renal perfusion in healthy volunteers at 3 Tesla

Keith A Gillis et al. BMC Nephrol. .

Abstract

Background: Measurement of renal perfusion is a crucial part of measuring kidney function. Arterial spin labelling magnetic resonance imaging (ASL MRI) is a non-invasive method of measuring renal perfusion using magnetised blood as endogenous contrast. We studied the reproducibility of ASL MRI in normal volunteers.

Methods: ASL MRI was performed in healthy volunteers on 2 occasions using a 3.0 Tesla MRI scanner with flow-sensitive alternating inversion recovery (FAIR) perfusion preparation with a steady state free precession (True-FISP) pulse sequence. Kidney volume was measured from the scanned images. Routine serum and urine biochemistry were measured prior to MRI scanning.

Results: 12 volunteers were recruited yielding 24 kidneys, with a mean participant age of 44.1 ± 14.6 years, blood pressure of 136/82 mmHg and chronic kidney disease epidemiology formula estimated glomerular filtration rate (CKD EPI eGFR) of 98.3 ± 15.1 ml/min/1.73 m2. Mean kidney volumes measured using the ellipsoid formula and voxel count method were 123.5 ± 25.5 cm3, and 156.7 ± 28.9 cm3 respectively. Mean kidney perfusion was 229 ± 41 ml/min/100 g and mean cortical perfusion was 327 ± 63 ml/min/100 g, with no significant differences between ASL MRIs. Mean absolute kidney perfusion calculated from kidney volume measured during the scan was 373 ± 71 ml/min. Bland Altman plots were constructed of the cortical and whole kidney perfusion measurements made at ASL MRIs 1 and 2. These showed good agreement between measurements, with a random distribution of means plotted against differences observed. The intra class correlation for cortical perfusion was 0.85, whilst the within subject coefficient of variance was 9.2%. The intra class correlation for whole kidney perfusion was 0.86, whilst the within subject coefficient of variance was 7.1%.

Conclusions: ASL MRI at 3.0 Tesla provides a repeatable method of measuring renal perfusion in healthy subjects without the need for administration of exogenous compounds. We have established normal values for renal perfusion using ASL MRI in a cohort of healthy volunteers.

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Figures

Figure 1
Figure 1
Renal arterial spin labelling MRI images. a. Single contrast ASL image. b. M0 image demonstrating magnetisation equilibrium c. T1 map. d. Composite image of 5 ASL MRI contrast images registered with post processing software.
Figure 2
Figure 2
Correlation plot of voxel count and ellipsoid formula methods of renal volume measurement using MRI. R is the Pearson correlation coefficient.
Figure 3
Figure 3
Correlation of kidney perfusion measured in left and right kidneys. R is the Pearson correlation coefficient.
Figure 4
Figure 4
Correlation between whole and cortical kidney perfusion measurements made at MRI 1 and 2. R is the Pearson correlation coefficient.
Figure 5
Figure 5
Bland Altman plot of cortical perfusion measurements made at MRI 1 and 2. Solid line and adjacent number indicates mean difference, whilst dashed line and number indicates limits of agreement.
Figure 6
Figure 6
Bland Altman plot of whole kidney perfusion measurements at MRI 1 and 2. Solid line and adjacent number indicates mean difference, whilst dashed line and number indicates limits of agreement.
See this image and copyright information in PMC

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