Proton MR study of different types of experimental acute renal failure in rats

MRI Mapping of Renal T1: Basic Concept

In renal MRI, measurement of the T₁ relaxation time of water molecules may provide a valuable biomarker for a variety of pathological conditions. Due to its sensitivity to the tissue microenvironment, T₁ has gained substantial interest for noninvasive imaging of renal pathology, including inflammation and fibrosis. In this chapter, we will discuss the basic concept of T₁ mapping and different T₁ measurement techniques and we will provide an overview of emerging preclinical applications of T₁ for imaging of kidney disease.This chapter is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This introduction chapter is complemented by two separate chapters describing the experimental procedure and data analysis.

Relationship between MRI and morphometric kidney measurements in diabetic and non-diabetic rats

The aim of the present study was to determine the applicability of magnetic resonance imaging (MRI) as a non-invasive measure of kidney volume in vivo in diabetic and non-diabetic rats. Magnetic resonance, T1 weighted Spin Echo, images were obtained after injection of contrast in anesthetized control (N = 14) and hyperglycemic streptozotocin (STZ)-diabetic rats (N = 14). On MRI imaging the total kidney, cortex, medullary and pelvic volumes were calculated. Immediately after MRI measurements the left kidneys were removed before weighing either as a clamped kidney weight (that is, the kidney containing blood and urine) or as a wet kidney weight (the kidney drained of blood and urine), while the right kidneys were perfusion-fixed for morphometric measurements. On thin kidney slices obtained from perfusion-fixed kidneys the cortex, medullary and pelvic fractions were measured and subsequently the cortex, medulla and pelvic volumes were calculated. The cortical volume was measured according to three different approaches. The corticomedullary boundary was defined either to the arcuate arteries, to a curved line following the glomeruli, or to a line at the top of the medullary rays. Both in control and diabetic rats, MRI measured kidney volumes were similar to the volume of perfusion-fixed kidneys, while the clamped kidney weight, and in particular the wet kidney weights, were smaller than the MRI obtained volumes. Good agreement was found between the MRI measured cortex and medulla volumes when the cortex was defined to the top of the medullary rays in the morphometric analysis. In conclusion, the present study demonstrates that MRI allows a reliable non-invasive estimate of renal morphology at a macroscopic level in both diabetic and non-diabetic rats.

MR findings in diffuse renal parenchymal disease

This study evaluates the MR appearance of the kidney in diffuse renal parenchymal diseases, using precontrast, and immediate and delayed postgadolinium chelate (Gd), spoiled gradient echo (SGE), and pre- and post-Gd, T1-weighted, fat-suppressed spin-echo MR images to determine if characteristic findings exist for various types of renal disease. One hundred twenty-one patients with renal disease underwent MRI. Underlying diagnoses included: (a) glomerular disease (GD), (b) tubulointerstitial disease (TID), (c) microvascular disease (MVD), (d) ischemic nephropathy (INP), (e) obstructive nephropathy (ON), (f) infectious renal disease (IRD), (g) sickle cell disease (SCD), (h) renal cortical necrosis (CN), and (i) renal insufficiency of unknown etiology (UE). MR examinations of 22 patients with normal kidneys (NK) were evaluated as a control group. The presence of corticomedullary differentiation (CMD) demonstrated strong inverse correlation with serum creatinine concentration (SCr) (r = -.568, P < .001). Mean thickness of the renal cortex was 8.4 and 7.8 mm in patients with NK and Gd, respectively. The mean cortical thickness in patients with MVD, TID/Chemo, INP, and ON was 5.2, 5.6, 5.5, and 4.3 mm, respectively, significantly thinner than the renal cortex in the NK and GD groups (P < .01). Irregularity of the renal cortex was more frequent in MVD (60.9%), IRD (62.5%), ON (55.6%), and TID/other (53.8%) than in GD (3.8%) and NK (0%) (P < .01). Diffuse high SI of the entire medulla on delayed postcontrast images was observed in 25 (20.7%) of the patients with renal disease and none of the NK group. Although no pathognomonic features were found, certain findings were observed that may correlate with the etiology of the kidney disease and, therefore, assist in the differential diagnosis of renal parenchymal disease.

In vivo proton magnetic resonance imaging and localized spectroscopic analysis of polycystic kidney disease in DBA/2FG-pyc mice

Proton magnetic resonance imaging (MRI) and localized spectroscopy techniques were used to study polycystic kidney disease (PKD) in DBA/2FG-pcy (pcy) mice, which are an animal model for the adult form of human PKD. A volume selective spectroscopy (VOSY) method was used to obtain localized proton spectra as well as apparent T1 and T2 relaxation times of the kidneys of either pcy or DBA/2FG normal (DBA) mice. Localization of the proton spectra was based on spatial coordinates determined from the proton images. Increases in apparent kidney T1 and T2 relaxation times were observed for pcy mice in comparison to those measured in DBA mice. Localized kidney T1 values from pcy mice were found to range from 799 to 1395 msec whereas DBA mice kidney T1 values were 617 to 774 msec. Localized T2 values measured from pcy mice kidneys ranged from 90 to 172 msec in comparison to kidney T2 values of 50 to 72 msec for DBA mice. The onset of cyst formation in the kidneys of pcy mice as a function of age was also studied. As early as 4 to 5 weeks of age it was possible to detect in vivo changes in pcy mice kidney T1 and T2 values.

Magnetic resonance imaging (MRI) and pathophysiology of the rat kidney in streptozotocin-induced diabetes

Proton magnetic resonance imaging was performed on rats before induction of diabetes with streptozotocin (STZ) and at 2 and 12 days postinduction. Images revealed an increase in maximal longitudinal and axial dimensions of the kidneys at 2 days and a further increase at 12 days. Similarly, an increase in the size of the remaining kidney was seen in a rat which underwent uninephrectomy as a positive control. Two major differences were observed between the kidney undergoing compensatory hypertrophy and those developing diabetic nephropathy: (i) Expansion of the renal vasculature was seen only in images of the diabetic rat; (ii) A loss in conspicuity of the normal corticomedullary junction was seen in the T2-weighted images of the diabetic rat but not in the uninephrectomized rat. Histologic examination revealed that the medulla increased to a size greater than the cortex during diabetic nephropathy whereas the medullary volume was less than that of the cortex during compensatory hypertrophy. In vitro T1 relaxation times in cortex, outer medulla and inner medulla of kidneys from control rats were measured and compared with the same respective regions in diabetic rats. When these values were correlated with tissue water content, a linear increase in relaxation rate versus percent water content from cortex to inner medulla was found in the control kidneys, but this correlation was absent in diabetic nephropathy. These studies demonstrate that MRI is an effective noninvasive tool for studying the course of renal hypertrophy and hydration changes in the development of renal disease in STZ-induced diabetes in the rat.

Paramagnetic enhanced proton magnetic resonance measurement in rats: correlates with renal function

Renal cortical, medullar and papillary T1 and T2 relaxation times were measured in rats with normal (n = 13) and impaired renal function (n = 11) with a Bruker Multispec, 20 MHz at 37 degrees C. In one group of seven rats, decreased renal function was obtained by 50% glycerol solution administration (10 ml/kg-body weight) 24 hours before the experiment, while in another group of four rats the renal function was decreased, by ureteral ligation for 72 hours. Immediately after the excision of one kidney, Gadolinium-DTPA (70 mumole/kg body weight) was injected intravenously. The second kidney was excised 5 min later. From the T1 and T2 relaxation times measured in the cortex, medulla, and papilla, their respective ratios before and after GdDTPA administration were calculated and correlated with GFR determined by creatinine clearance (Ccr range was between 0 and 850 microliters/min/g kidney weight). For T1: the ratios in the cortex, medulla, and papilla the correlation coefficients were r = 0.81 (p less than 0.001), r = 0.85 (p less than 0.001), and r = 0.87 (p less than 0.0001), respectively. The respective correlation coefficient r values for T2 were r = 0.38 (NS), r = 0.76 (p less than 0.001), and r = 0.73 (p less than 0.001). The present study indicates that a combination of MR measurements, with and without GdDTPA paramagnetic enhancement, can offer a new possibility for obtaining information on renal function and suggest the possibility of concomitant anatomo functional magnetic resonance imaging.

Proton magnetic resonance in experimental acute and chronic renal failure in rats

Kidney cortical and medullary "spin-lattice" (T1) and "spin-spin" (T2) relaxation times were measured by spectroscopy in several types of experimental renal failure in rats. The T1 and the measured tissue water content were used to calculate the fraction bound (FB) and hydration fraction (HF) according to a fast proton diffusion model. The present study demonstrated the possibility to differentiate between normal and pathological renal tissue resulting from renal artery clamping (RAC), renal pedicle clamping (RPC) with or without reflow, glycerol-induced acute renal failure with or without previous dehydration, and chronic hypertensive renal failure induced by 5/6 nephrectomy and saline loading, with low (6%) or normal (21%) protein diet. Shortened T1 and prolonged T2 found in both cortex and medulla of the glycerol-induced ARF in dehydrated rats seem to represent a MR ischemic pattern. The prolongation of T1 and T2 and the increase in water content in the other groups seem to relate to different amounts of tubular obstruction and renal congestion. In summary, characteristic MR properties of different types of renal failure may provide etiological and pathogenetic diagnostic possibilities.