To evaluate the reproducibility and utility of quantitative magnetic resonance imaging (MRI) sequences for the assessment of kidneys in young adults with normal renal function (eGFR ranged from 90 to 130 mL/min/1.73 m2) and patients with early renal disease (autosomal dominant polycystic kidney disease).
Materials and methods
This prospective case–control study was performed on ten normal young adults (18–30 years old) and ten age- and sex-matched patients with early renal parenchymal disease (autosomal dominant polycystic kidney disease). All subjects underwent a comprehensive kidney MRI protocol, including qualitative imaging: T1w, T2w, FIESTA, and quantitative imaging: 2D cine phase contrast of the renal arteries, and parenchymal diffusion weighted imaging (DWI), magnetization transfer imaging (MTI), blood oxygen level dependent (BOLD) imaging, and magnetic resonance elastography (MRE). The normal controls were imaged on two separate occasions ≥24 h apart (range 24–210 h) to assess reproducibility of the measurements.
Quantitative MR imaging sequences were found to be reproducible. The mean ± SD absolute percent difference between quantitative parameters measured ≥24 h apart were: MTI-derived ratio = 4.5 ± 3.6%, DWI-derived apparent diffusion coefficient (ADC) = 6.5 ± 3.4%, BOLD-derived R2* = 7.4 ± 5.9%, and MRE-derived tissue stiffness = 7.6 ± 3.3%. Compared with controls, the ADPKD patient’s non-cystic renal parenchyma (NCRP) had statistically significant differences with regard to quantitative parenchymal measures: lower MTI percent ratios (16.3 ± 4.4 vs. 23.8 ± 1.2, p < 0.05), higher ADCs (2.46 ± 0.20 vs. 2.18 ± 0.10 × 10−3 mm2/s, p < 0.05), lower R2*s (14.9 ± 1.7 vs. 18.1 ± 1.6 s−1, p < 0.05), and lower tissue stiffness (3.2 ± 0.3 vs. 3.8 ± 0.5 kPa, p < 0.05).
Excellent reproducibility of the quantitative measurements was obtained in all cases. Significantly different quantitative MR parenchymal measurement parameters between ADPKD patients and normal controls were obtained by MT, DWI, BOLD, and MRE indicating the potential for detecting and following renal disease at an earlier stage than the conventional qualitative imaging techniques.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
National Center for Health Statistics, Summary Health Statistics Tables for U.S. Adults: National Health Interview Survey, 2014, Table A-4b, A-4c.
National Center for Health Statistics, Deaths: Final Data for 2014, Tables 9, 10, 11.
Smith HW (1953) Compar physiology of the kidney. J Am Med Assoc 153:1512–1514
Myers GL, Miller WG, Coresh J, et al. (2006) Recommendations for improving serum creatinine measurement: a report from the laboratory working group of the National Kidney Disease Education Program. Clin Chem 52:5–18
Coresh J, Astor BC, McQuillan G, et al. (2002) Calibration and random variation of the serum creatinine assay as critical elements of using equations to estimate glomerular filtration rate. Am J Kidney Dis 39:920–929
Zhang JL, Morrell G, Rusinek H, et al. (2014) New magnetic resonance imaging methods in nephrology. Kidney Int 85:768–778
Kajander S, Kallio T, Alanen A, Komu M, Forsstrom J (2000) Imaging end-stage kidney disease in adults. Low-field MR imaging with magnetization transfer vs. ultrasonography. Acta Radiol 41:357–360
Ebrahimi B, Macura SI, Knudsen BE, Grande JP, Lerman LO (2013) Fibrosis detection in renal artery stenosis mouse model using magnetization transfer MRI. Proc. SPIE 8672, Medical Imaging 2013: Biomedical Applications in Molecular, Structural, and Functional Imaging, 867205 8672:867
Kline TL, Irazabal MV, Ebrahimi B, et al. (2016) Utilizing magnetization transfer imaging to investigate tissue remodeling in a murine model of autosomal dominant polycystic kidney disease. Magn Reson Med 75:1466–1473
Sourbron SP, Michaely HJ, Reiser MF, Schoenberg SO (2008) MRI-measurement of perfusion and glomerular filtration in the human kidney with a separable compartment model. Investig Radiol 43:40–48
Li LP, Halter S, Prasad PV (2008) Blood oxygen level-dependent MR imaging of the kidneys. Magn Reson Imaging Clin N Am 16:613–625
Pedersen M, Dissing TH, Morkenborg J, et al. (2005) Validation of quantitative BOLD MRI measurements in kidney: application to unilateral ureteral obstruction. Kidney Int 67:2305–2312
Prasad PV, Edelman RR, Epstein FH (1996) Noninvasive evaluation of intrarenal oxygenation with BOLD MRI. Circulation 94:3271–3275
Khatir DS, Pedersen M, Jespersen B, Buus NH (2014) Reproducibility of MRI renal artery blood flow and BOLD measurements in patients with chronic kidney disease and healthy controls. J Magn Reson Imaging 40:1091–1098
King BF, Torres VE, Brummer ME, et al. (2003) Magnetic resonance measurements of renal blood flow as a marker of disease severity in autosomal-dominant polycystic kidney disease. Kidney Int 64:2214–2221
Torres VE, King BF, Chapman AB, et al. (2007) Magnetic resonance measurements of renal blood flow and disease progression in autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol 2:112–120
Karger N, Biederer J, Lusse S, et al. (2000) Quantitation of renal perfusion using arterial spin labeling with FAIR-UFLARE. Magn Reson Imaging 18:641–647
Martirosian P, Boss A, Schraml C, et al. (2010) Magnetic resonance perfusion imaging without contrast media. Eur J Nucl Med Mol I 37:S52–S64
Warner L, Yin M, Glaser KJ, et al. (2011) Noninvasive In vivo assessment of renal tissue elasticity during graded renal ischemia using MR elastography. Investig Radiol 46:509–514
Maril N, Margalit R, Mispelter J, Degani H (2004) Functional sodium magnetic resonance imaging of the intact rat kidney. Kidney Int 65:927–935
Thoeny HC, De Keyzer F, Oyen RH, Peeters RR (2005) Diffusion-weighted MR imaging of kidneys in healthy volunteers and patients with parenchymal diseases: initial experience. Radiology 235:911–917
Chandarana H, Lee VS, Hecht E, Taouli B, Sigmund EE (2011) Comparison of biexponential and monoexponential model of diffusion weighted imaging in evaluation of renal lesions: preliminary experience. Investig Radiol 46:285–291
Wang F, Kopylov D, Zu Z, et al. (2015) Mapping murine diabetic kidney disease using chemical exchange saturation transfer MRI. Magn Reson Med 76(5):1531–1541
Kline TL, Edwards ME, Korfiatis P, et al. (2016) Semiautomated segmentation of polycystic kidneys in T2-weighted MR images. Am J Roentgenol 207:605–613
Altman DG, Bland JM (1983) Measurement in medicine—the analysis of method comparison studies. Statistician 32:307–317
Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310
Sesso HD, Stampfer MJ, Rosner B, et al. (2000) Systolic and diastolic blood pressure, pulse pressure, and mean arterial pressure as predictors of cardiovascular disease risk in men. Hypertension 36:801–807
Spiering W, Kroon AA, Fuss-Lejeune MM, Daemen MJ, de Leeuw PW (2000) Angiotensin II sensitivity is associated with the angiotensin II type 1 receptor A(1166)C polymorphism in essential hypertensives on a high sodium diet. Hypertension 36:411–416
This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases under NIH Grant/Award Number P30 DK090728 “Mayo Translational PKD Center (MTPC),” Robert M. and Billie Kelley Pirnie, the PKD Foundation Grant 206g16a, and the National Cancer Institute (NCI) under Grant/Award CA160045.
Conflict of interest
T.L.K. declares that he has no conflict of interest. M.E.E declares that she has no conflict of interest. I.G. declares that he has no conflict of interest. M.V.I. declares that she has no conflict of interest. P.K. declares that he has no conflict of interest. P.C.H. declares that he has no conflict of interest. B.F.K. declares that he has no conflict of interest. V.E.T. declares that he has no conflict of interest. S.K.V. declares that he has no conflict of interest. B.J.E. declares that he has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
About this article
Cite this article
Kline, T.L., Edwards, M.E., Garg, I. et al. Quantitative MRI of kidneys in renal disease. Abdom Radiol 43, 629–638 (2018). https://doi.org/10.1007/s00261-017-1236-y
- Autosomal dominant polycystic kidney disease
- Magnetic resonance imaging
- Quantitative magnetic resonance imaging
- Total kidney volume