Skip to main content
SpringerLink
Log in

One-stop assessment of renal function and renal artery in hypertensive patients with suspected renal dysfunction: non-enhanced MRI using spatial labeling with multiple inversion pulses

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To assess whether spatial labeling with multiple inversion pulses (SLEEK) sequence can be employed as a one-stop assessment method for evaluating renal function and displaying renal artery in hypertensive patients with suspected renal dysfunction.

Methods

A total of 78 patients with suspected hypertensive renal damage were enrolled in this retrospective study. All patients underwent MRI examinations, and both SLEEK and DWI sequences were performed simultaneously. According to estimated glomerular filtration rate (eGFR), patients were divided into three groups (Group 1, eGFR> 90; Group 2, eGFR = 60–90; Group 3, eGFR< 60). Twenty-two of these patients also underwent CT angiography (CTA) examination. Comparison between CTA, DWI, and eGFR was performed to assess the value of SLEEK in evaluating renal function and displaying renal artery.

Results

The performance of SLEEK to display renal artery was highly consistent with the results of CTA (kappa = 0.713). The corticomedullary contrast ratio positively correlated with eGFR (p = 0.004, r = 0.322) and was significantly higher in SLEEK images than in DWI images in all three groups (p < 0.001). There was no significant difference in corticomedullary contrast ratio in SLEEK images between Group 1 and Group 2 (p = 0.285). However, the minimal renal cortical thickness, which significantly correlated with eGFR (p < 0.001, r = 0.866), was significantly different between Group 1 and Group 2 (p < 0.001). ROC analysis showed good diagnostic performance when differentiating patients with eGFR> 60 from those with eGFR< 60.

Conclusions

The SLEEK sequence could evaluate simultaneously renal function through corticomedullary differentiation and renal arteries, enabling one-stop assessment in hypertensive patients with suspected renal dysfunction.

Key Points

• Spatial labeling with multiple inversion pulses (SLEEK) improves renal corticomedullary differentiation in hypertensive patients with renal dysfunction compared with DWI.

• SLEEK clearly displays renal artery in hypertensive patients with renal dysfunction.

• SLEEK could be utilized as a one-stop assessment method for evaluating renal function and renal artery in hypertensive patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

The areas under the receiver operating characteristic curves

BSP TI:

Blood-suppression inversion times

CE-MRI:

Contrast-enhanced magnetic resonance imaging

CKD:

Chronic kidney disease

CTA:

Computed tomography angiography

DWI:

Diffusion-weighted imaging

eGFR:

Estimated glomerular filtration rate

ICC:

Intraclass correlation coefficient

ROC:

Receiver operating characteristic

ROI:

Regions of interest

SI:

Signal intensity

SLEEK:

Spatial labeling with multiple inversion pulses

References

  1. Messerli FH, Williams B, Ritz E (2007) Essential hypertension. Lancet 370:591–603

    Article  CAS  Google Scholar 

  2. Hamrahian SM, Falkner B (2017) Hypertension in chronic kidney disease. Adv Exp Med Biol 956:307–325

    Article  Google Scholar 

  3. Shemesh O, Golbetz H, Kriss JP, Myers BD (1985) Limitations of creatinine as a filtration marker in glomerulopathic patients. Kidney Int 28:830–838

    Article  CAS  Google Scholar 

  4. Eikefjord E, Andersen E, Hodneland E et al (2017) Dynamic contrast-enhanced MRI measurement of renal function in healthy participants. Acta Radiol 58:748–757

    Article  Google Scholar 

  5. Slanina M, Zizka J, Klzo L, Lojík M (2010) Contrast-enhanced MR angiography utilizing parallel acquisition techniques in renal artery stenosis detection. Eur J Radiol 75:e46–e50

    Article  Google Scholar 

  6. Heverhagen JT, Krombach GA, Gizewski E (2014) Application of extracellular gadolinium-based MRI contrast agents and the risk of nephrogenic systemic fibrosis. Rofo 186:661–669

    Article  CAS  Google Scholar 

  7. Otsuka T, Kaneko Y, Sato Y et al (2018) 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. Clin Exp Nephrol 22:45–54

    Article  CAS  Google Scholar 

  8. Noda Y, Ito K, Kanki A et al (2015) Measurement of renal cortical thickness using noncontrast-enhanced steady-state free precession MRI with spatially selective inversion recovery pulse: association with renal function. J Magn Reson Imaging 41:1615–1621

    Article  Google Scholar 

  9. Li Q, Wang D, Zhu X, Shen K, Xu F, Chen Y (2018) Combination of renal apparent diffusion coefficient and renal parenchymal volume for better assessment of split renal function in chronic kidney disease. Eur J Radiol 108:194–200

    Article  Google Scholar 

  10. Li Q, Li J, Zhang L, Chen Y, Zhang M, Yan F (2014) Diffusion-weighted imaging in assessing renal pathology of chronic kidney disease: a preliminary clinical study. Eur J Radiol 83:756–762

    Article  Google Scholar 

  11. Ding J, Chen J, Jiang Z, Zhou H, Di J, Xing W (2016) Assessment of renal dysfunction with diffusion-weighted imaging: comparing intra-voxel incoherent motion (IVIM) with a mono-exponential model. Acta Radiol 57:507–512

    Article  Google Scholar 

  12. Takahashi T, Wang F, Quarles CC (2015) Current MRI techniques for the assessment of renal disease. Curr Opin Nephrol Hypertens 24:217–223

    Article  Google Scholar 

  13. 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

    Article  Google Scholar 

  14. Kanki A, Ito K, Tamada T et al (2013) Corticomedullary differentiation of the kidney: evaluation with noncontrast-enhanced steady-state free precession (SSFP) MRI with time-spatial labeling inversion pulse (time-SLIP). J Magn Reson Imaging 37:1178–1181

    Article  Google Scholar 

  15. Kanki A, Ito K, Yamamoto A et al (2016) Evaluation of renal cortical thickness by non-contrast-enhanced MR imaging with spatially selective IR pulses: comparison between cirrhotic and non-cirrhotic patients. Br J Radiol. https://doi.org/10.1259/bjr.20150803:20150803

  16. Pei Y, Shen H, Li J et al (2012) Evaluation of renal artery in hypertensive patients by unenhanced MR angiography using spatial labeling with multiple inversion pulses sequence and by CT angiography. AJR Am J Roentgenol 199:1142–1148

    Article  Google Scholar 

  17. Tang H, Wang Z, Wang L et al (2014) Depiction of transplant renal vascular anatomy and complications: unenhanced MR angiography by using spatial labeling with multiple inversion pulses. Radiology 271:879–887

    Article  Google Scholar 

  18. Wang HY, Wang J, Tang YH, Ye HY, Ma L (2015) Coronal diffusion-weighted magnetic resonance imaging of the kidney: agreement with axial diffusion-weighted magnetic imaging in terms of apparent diffusion coefficient values. Chin Med J (Engl) 128:499–503

    Article  Google Scholar 

  19. Guo X, Gong Y, Wu Z, Yan F, Ding X, Xu X (2020) Renal artery assessment with non-enhanced MR angiography versus digital subtraction angiography: comparison between 1.5 and 3.0 T. Eur Radiol 30:1747–1754

    Article  Google Scholar 

  20. Xu X, Lin X, Huang J et al (2017) The capability of inflow inversion recovery magnetic resonance compared to contrast-enhanced magnetic resonance in renal artery angiography. Abdom Radiol (NY) 42:2479–2487

    Article  Google Scholar 

  21. Zhang LJ, Peng J, Wen J et al (2018) Non-contrast-enhanced magnetic resonance angiography: a reliable clinical tool for evaluating transplant renal artery stenosis. Eur Radiol 28:4195–4204

    Article  Google Scholar 

  22. Xu Y, Wang X, Jiang X (2007) Relationship between the renal apparent diffusion coefficient and glomerular filtration rate: preliminary experience. J Magn Reson Imaging 26:678–681

    Article  Google Scholar 

  23. Yalçin-Şafak K, Ayyildiz M, Ünel SY, Umarusman-Tanju N, Akça A, Baysal T (2016) The relationship of ADC values of renal parenchyma with CKD stage and serum creatinine levels. Eur J Radiol Open 3:8–11

    Article  Google Scholar 

  24. de Bazelaire CMJ, Duhamel GD, Rofsky NM, Alsop DC (2004) MR imaging relaxation times of abdominal and pelvic tissues measured in vivo at 3.0 T: preliminary results. Radiology 230:652–659

    Article  Google Scholar 

  25. Garcia DM, Duhamel G, Alsop DC (2005) Efficiency of inversion pulses for background suppressed arterial spin labeling. Magn Reson Med 54:366–372

    Article  Google Scholar 

  26. Denic A, Mathew J, Nagineni VV et al (2018) Clinical and pathology findings associate consistently with larger glomerular volume. J Am Soc Nephrol 29:1960–1969

    Article  CAS  Google Scholar 

  27. Seif M, Eisenberger U, Binser T et al (2016) Renal blood oxygenation level-dependent imaging in longitudinal follow-up of donated and remaining kidneys. Radiology 279:795–804

    Article  Google Scholar 

  28. Graham-Brown MP, Singh A, Wormleighton J et al (2019) Association between native T1 mapping of the kidney and renal fibrosis in patients with IgA nephropathy. BMC Nephrol 20:256–256

    Article  CAS  Google Scholar 

  29. Franke M, Baeßler B, Vechtel J et al (2017) Magnetic resonance T2 mapping and diffusion-weighted imaging for early detection of cystogenesis and response to therapy in a mouse model of polycystic kidney disease. Kidney Int 92:1544–1554

    Article  Google Scholar 

  30. Bane O, Hectors SJ, Gordic S et al (2020) Multiparametric magnetic resonance imaging shows promising results to assess renal transplant dysfunction with fibrosis. Kidney Int 97:414–420

    Article  CAS  Google Scholar 

Download references

Acknowledgments

We thank Yaqi Shen, Fangqin Tan, and Jie Zhang, whose important contributions to this study were indispensable to its success.

Funding

This study has received funding by the National Natural Science Foundation of China (Grant No. 81771801 and No. 81571642).

Author information

Authors and Affiliations

  1. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

    Ping Liang, Chuou Xu, Pratik Tripathi, Jiali Li, Anqin Li, Daoyu Hu & Zhen Li

  2. Russell H. Morgan Department of Radiology and Radiological Science, the Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Ihab Kamel

Authors
  1. Ping Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chuou Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pratik Tripathi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jiali Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anqin Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Daoyu Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ihab Kamel
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Zhen Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zhen Li.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Zhen Li.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Written informed consent was obtained from all subjects (patients) in this study.

Methodology

• retrospective

• diagnostic and prognostic study

• performed at one institution

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liang, P., Xu, C., Tripathi, P. et al. One-stop assessment of renal function and renal artery in hypertensive patients with suspected renal dysfunction: non-enhanced MRI using spatial labeling with multiple inversion pulses. Eur Radiol 31, 94–103 (2021). https://doi.org/10.1007/s00330-020-07088-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-020-07088-x

Keywords

Search

Navigation