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Oh D, Lee D, Heo J, Kweon J, Yong U, Jang J, Ahn YJ, Kim C. Contrast Agent-Free 3D Renal Ultrafast Doppler Imaging Reveals Vascular Dysfunction in Acute and Diabetic Kidney Diseases. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2303966. [PMID: 37847902 PMCID: PMC10754092 DOI: 10.1002/advs.202303966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/19/2023] [Indexed: 10/19/2023]
Abstract
To combat the irreversible decline in renal function associated with kidney disease, it is essential to establish non-invasive biomarkers for assessing renal microcirculation. However, the limited resolution and/or vascular sensitivity of existing diagnostic imaging techniques hinders the visualization of complex cortical vessels. Here, a 3D renal ultrafast Doppler (UFD) imaging system that uses a high ultrasound frequency (18 MHz) and ultrahigh frame rate (1 KHz per slice) to scan the entire volume of a rat's kidney in vivo is demonstrated. The system, which can visualize the full 3D renal vascular branching pyramid at a resolution of 167 µm without any contrast agent, is used to chronically and noninvasively monitor kidneys with acute kidney injury (AKI, 3 days) and diabetic kidney disease (DKD, 8 weeks). Multiparametric UFD analyses (e.g., vessel volume occupancy (VVO), fractional moving blood volume (FMBV), vessel number density (VND), and vessel tortuosity (VT)) describe rapid vascular rarefaction from AKI and long-term vascular degeneration from DKD, while the renal pathogeneses are validated by in vitro blood serum testing and stained histopathology. This work demonstrates the potential of 3D renal UFD to offer valuable insights into assessing kidney perfusion levels for future research in diabetes and kidney transplantation.
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Affiliation(s)
- Donghyeon Oh
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Donghyun Lee
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Jinseok Heo
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Jooyoung Kweon
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Uijung Yong
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Jinah Jang
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Yong Joo Ahn
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Chulhong Kim
- Departments of Electrical EngineeringConvergence IT EngineeringMedical Science and EngineeringMechanical Engineeringand Medical Device Innovation CenterPohang University of Science and Technology (POSTECH)Cheongam‐ro 77, Nam‐guPohangGyeongbuk37673Republic of Korea
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Ifergan G, Autret G, Del Giudice C, Lecler A, Lalot A, Marijon C, Casanova A, Perez-Liva M, Bellamy V, Bruneval P, Clement O, Sapoval M, Menasché P, Balvay D. Dynamic contrast enhanced - MRI efficiency in detecting embolization-induced perfusion defects in a rabbit model of critical-limb-ischemia. Magn Reson Imaging 2022; 87:88-96. [PMID: 35026346 DOI: 10.1016/j.mri.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/21/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
Critical limb ischemia (CLI) is a severe disease which affects about 2 million people in the US. Its prevalence is assessed at 800/100,000 population. However, no reliable tools are currently available to assess perfusion defects at the muscle tissue level. DCE-MRI is a technique that holds the potential to be effective in achieving this goal. However, preclinical studies performed with DCE-MRI have indicated low sensitivity assessing perfusion at resting state. To improve these previous results, in this work we propose new methodologies for data acquisition and analysis and we also revisit the biological model used for evaluation. Eleven rabbits underwent embolization of a lower limb. They were imaged at day 7 after embolization using DCE-MRI, performed on a 4.7 T small imaging device. Among them, n = 4 rabbits were used for MRI sequence optimization and n = 6 for data analysis after one exclusion. Normalized Areas under the curve (AUCn), and kinetic parameters such as Ktrans and Vd resulting from the Tofts-Kety modeling (KTM) were calculated on the embolized and contralateral limbs. Average and heterogeneity features, consisting on standard-deviation and quantiles, were calculated on muscle groups and whole limbs. The Wilcoxon and Fisher-tests were performed to compare embolized and contralateral regions of interests. The Wilcoxon test was also used to compare features of parametric maps. Quantiles of 5 and 95% in the contralateral side were used to define low and high outliers. A P-value <0.05 was considered statistically significant. Average features were inefficient to identify injured muscles, in agreement with the low sensitivity of the technique previously reported by the literature. However, these findings were dramatically improved by the use of additional heterogeneity features (97% of total accuracy for group muscles, P < 0.01 and 100% of total accuracy for the total limbs). The mapping analysis and automatic outlier detection quantification improvement was explained by the presence of local hyperemia that impair the average calculations. The analysis with KTM did not provide any additional information compared to AUCn. The DCE technique can be effective in detecting embolization-induced disorders of limb muscles in a CLI model when heterogeneity is taken into account in the data processing, even without vascular stimulation. The simultaneous presence of areas of ischemia and hyperemia appeared as a signature of the injured limbs. These areas seem to reflect the simultaneous presence of infarcted areas and viable peripheral areas, characterized by a vascular response that is visible in DCE.
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Affiliation(s)
- Gabriel Ifergan
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
| | - Gwennhael Autret
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
| | - Costantino Del Giudice
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Interventional Radiology / Radiology / Anatomy Pathology /horacic and cardiovascular surgery, Hôpital Européen Georges Pompidou, APHP, France.
| | - Augustin Lecler
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Fondation Ophtalmologique Adolphe de Rothschild, France.
| | - Adrien Lalot
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France
| | - Camille Marijon
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
| | - Amaury Casanova
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France
| | - Mailyn Perez-Liva
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
| | - Valérie Bellamy
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
| | - Patrick Bruneval
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Interventional Radiology / Radiology / Anatomy Pathology /horacic and cardiovascular surgery, Hôpital Européen Georges Pompidou, APHP, France.
| | - Olivier Clement
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Interventional Radiology / Radiology / Anatomy Pathology /horacic and cardiovascular surgery, Hôpital Européen Georges Pompidou, APHP, France.
| | - Marc Sapoval
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Interventional Radiology / Radiology / Anatomy Pathology /horacic and cardiovascular surgery, Hôpital Européen Georges Pompidou, APHP, France.
| | - Philippe Menasché
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France; Interventional Radiology / Radiology / Anatomy Pathology /horacic and cardiovascular surgery, Hôpital Européen Georges Pompidou, APHP, France.
| | - Daniel Balvay
- Regenerative Therapies for Cardiac and Vascular Diseases / In vivo Imaging Research / Integrative Epidemiology of Cardiovascular diseases, Université de PARIS, PARCC U970, INSERM, France.
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Liu B, Hu L, Wang L, Xing D, Peng L, Chen P, Zeng F, Liu WV, Liu H, Zha Y. Evaluation of microvascular permeability of skeletal muscle and texture analysis based on DCE-MRI in alloxan-induced diabetic rabbits. Eur Radiol 2021; 31:5669-5679. [PMID: 33547478 DOI: 10.1007/s00330-021-07705-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 11/24/2020] [Accepted: 01/21/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To estimate the microvascular permeability and perfusion of skeletal muscle by using quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and explore the feasibility of using texture analysis (TA) to evaluate subtle structural changes of diabetic muscles. METHODS Twenty-four rabbits were randomly divided into diabetic (n = 14) and control (n = 10) groups, and underwent axial DCE-MRI of the multifidus muscle (0, 4, 8, 12, and 16 weeks after alloxan injection). The pharmacokinetic model was used to calculate the permeability parameters; texture parameters were extracted from volume transfer constant (Ktrans) map. The two-sample t test/Mann-Whitney U test, repeated measures analysis of variance/Friedman test, and Pearson correlations were used for data analysis. RESULTS In the diabetic group, Ktrans and rate constant (Kep) increased significantly at week 8 and then showed a decreasing trend. Extravascular extracellular space volume fraction (Ve) increased and plasma volume fraction (Vp) decreased significantly from the 8th week. Skewness began to decrease at the 4th week. Median Ktrans and entropy increased significantly, while inverse difference moment decreased from the 8th week. Energy decreased while contrast increased only at week 8. Muscle fibre cross-sectional area was negatively correlated with Ve. The capillary-to-fibre ratio was positively correlated with Vp (p < 0.05, all). CONCLUSIONS Quantitative DCE-MRI can be used to evaluate microvascular permeability and perfusion in diabetic skeletal muscle at an early stage; TA based on Ktrans map can identify microarchitectural modifications in diabetic muscles. KEY POINTS • Four quantitative parameters of DCE-MRI can be used to evaluate microvascular permeability and perfusion of skeletal muscle in diabetic models at early stages. • Texture analysis based on Ktrans map can identify subtle structural changes in diabetic muscles.
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Affiliation(s)
- Baiyu Liu
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Lei Hu
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Li Wang
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Dong Xing
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Lin Peng
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Pianpian Chen
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Feifei Zeng
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | | | - Huan Liu
- GE Healthcare, Shanghai, 201203, China
| | - Yunfei Zha
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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Wang D, Zhang X, Lu L, Li H, Zhang F, Chen Y, Shen J. Assessment of diabetic peripheral neuropathy in streptozotocin-induced diabetic rats with magnetic resonance imaging. Eur Radiol 2014; 25:463-71. [PMID: 25204416 DOI: 10.1007/s00330-014-3423-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 08/12/2014] [Accepted: 08/28/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine the role of magnetic resonance (MR) imaging and quantitative T2 value measurements in the assessment of diabetic peripheral neuropathy (DPN). METHODS Sequential MR imaging, T2 measurement, and quantitative sensory testing of sciatic nerves were performed in streptozotocin-induced diabetic rats (n = 6) and normal control rats (n = 6) over a 7-week follow-up period. Histological assessment was obtained from 48 diabetic rats and 48 control rats once weekly for 7 weeks (n = 6 for each group at each time point). Nerve signal abnormalities were observed, and the T2 values, mechanical withdrawal threshold (MWT), and histological changes were measured and compared between diabetic and control animals. RESULTS Sciatic nerves in the diabetic rats showed a gradual increase in T2 values beginning at 2 weeks after the induction (P = 0.014), while a decrease in MWT started at 3 weeks after the induction (P = 0.001). Nerve T2 values had a similar time course to sensory functional deficit in diabetic rats. Histologically, sciatic nerves of diabetic rats demonstrated obvious endoneural oedema from 2 to 3 weeks after the induction, followed by progressive axonal degeneration, Schwann cell proliferation, and coexistent disarranged nerve regeneration. CONCLUSION Nerve T2 measurement is potentially useful in detecting and monitoring diabetic neuropathy. KEY POINTS • Sciatic nerves in diabetic rats showed a gradual increase in T2 values • Nerve T2 values were negatively correlated with sensory function impairment • Longitudinal T2 values can be used to monitor the disease progress • Nerve degeneration contributed mainly to progressive prolongation of nerve T2 values.
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Affiliation(s)
- Dongye Wang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, Guangdong, 51012, China
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