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Mao W, Ding Y, Ding X, Fu C, Cao B, Nickel D, Zhou J, Zeng M. Value of T1 Mapping in the Non-invasive Assessment of Renal Pathologic Injury for Chronic Kidney Disease Patients. Magn Reson Med Sci 2023:mp.2023-0027. [PMID: 38143088 DOI: 10.2463/mrms.mp.2023-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023] Open
Abstract
PURPOSE The objective of this study was to evaluate renal function and pathologic injury in chronic kidney disease (CKD) using T1 mapping. METHODS We recruited fifteen healthy volunteers (HV) and seventy-five CKD patients to undergo T1 mapping examination, and renal parenchymal T1 values were measured. Spearman correlation analysis was used to evaluate the relevance between the pathologic injury score, estimated glomerular filtration rate (eGFR), and renal parenchymal T1 values. The diagnostic efficiency of T1 value in evaluating renal pathologic impairment was assessed. RESULTS In all subjects, renal cortical T1 value was remarkably lower than renal medullary T1 value (P < 0.01). The renal medullary T1 value of HV was considerably lower than that of CKD patients in all stages (P < 0.05). The T1 values were negatively correlated with eGFR (cortex, r = -0.718; medulla, r = -0.645). The T1 values were positively correlated with glomerular injury score (cortex, r = 0.692; medulla, r = 0.632), tubulointerstitial injury score (cortex, r = 0.758; medulla, r = 0.690) (all P < 0.01). The area under the curve (AUC) of renal cortical and medullary T1 values were 0.914 and 0.880 to distinguish moderate-severe from mild renal injury groups. To differentiate mild renal injury group from control group, the AUC values of renal cortical and medullary T1 values were 0.879 and 0.856. CONCLUSION T1 mapping has potential application value in non-invasively assessing renal pathologic injury in CKD.
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Affiliation(s)
- Wei Mao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China
| | - Yuqin Ding
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Caixia Fu
- MR Applications Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China
| | - Bohong Cao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China
| | - Dominik Nickel
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Jianjun Zhou
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China
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Abstract
As a sign of chronic kidney disease (CKD) progression, renal fibrosis is an irreversible and alarming pathological change. The accurate diagnosis of renal fibrosis depends on the widely used renal biopsy, but this diagnostic modality is invasive and can easily lead to sampling error. With the development of imaging techniques, an increasing number of noninvasive imaging techniques, such as multipara meter magnetic resonance imaging (MRI) and ultrasound elastography, have gained attention in assessing kidney fibrosis. Depending on their ability to detect changes in tissue stiffness and diffusion of water molecules, ultrasound elastography and some MRI techniques can indirectly assess the degree of fibrosis. The worsening of renal tissue oxygenation and perfusion measured by blood oxygenation level-dependent MRI and arterial spin labeling MRI separately is also an indirect reflection of renal fibrosis. Objective and quantitative indices of fibrosis may be available in the future by using novel techniques, such as photoacoustic imaging and fluorescence microscopy. However, these imaging techniques are susceptible to interference or may not be convenient. Due to the lack of sufficient specificity and sensitivity, these imaging techniques are neither widely accepted nor proposed by clinicians. These obstructions must be overcome by conducting technology research and more prospective studies. In this review, we emphasize the recent advancement of these noninvasive imaging techniques and provide clinicians a continuously updated perspective on the assessment of kidney fibrosis.
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Affiliation(s)
- Buchun Jiang
- Department of Nephrology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China
| | - Fei Liu
- Department of Nephrology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China
| | - Haidong Fu
- Department of Nephrology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China,CONTACT Haidong Fu
| | - Jianhua Mao
- Department of Nephrology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China,Jianhua Mao The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, 3333 Bingsheng Rd, Hangzhou, Zhejiang310052, China
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Ma G, Chen F, Liu Y, Zheng L, Jiang X, Tian H, Wang X, Song X, Yu Y, Wang D. Nur77 ameliorates age-related renal tubulointerstitial fibrosis by suppressing the TGF-β/Smads signaling pathway. FASEB J 2022; 36:e22124. [PMID: 34972249 DOI: 10.1096/fj.202101332r] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/01/2021] [Accepted: 12/13/2021] [Indexed: 01/10/2023]
Abstract
Nerve growth factor-induced gene B (Nur77) has been shown to ameliorate several biological processes in chronic diseases, including inflammatory response, cellular proliferation, and metabolism. Chronic kidney disease (CKD) is characterized by tubulointerstitial fibrosis for which no targeted therapies are available as yet. In this study, we performed in vivo and in vitro experiments to demonstrate that Nur77 targets fibrosis signals and attenuates renal tubulointerstitial fibrosis during the aging process. We observed that the TGF-β/Smads signal pathway was significantly suppressed by Nur77, suggesting that Nur77 controlled the activation of key steps in TGF-β/Smads signaling. We further showed that Nur77 interacted with Smad7, the main repressor of nuclear translocation of Smad2/3, and stabilized Smad7 protein homeostasis. Nur77 deficiency resulted in Smad7 degradation, aggravating Smad2/3 phosphorylation, and promoting transcription of its downstream target genes, ACTA2 and collagen I. Our findings demonstrate that Nur77 is a potential therapeutic target for age-related kidney diseases including CKD. Maintenance of Nur77 may be an effective strategy for blocking renal tubulointerstitial fibrosis and improving renal function in the elderly.
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Affiliation(s)
- Guojing Ma
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang, China.,Key Laboratory of Medical Cell Biology, Institute of Translational Medicine, China Medical University, Shenyang, China
| | - Feng Chen
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yixuan Liu
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lixia Zheng
- Key Laboratory of Medical Cell Biology, Institute of Translational Medicine, China Medical University, Shenyang, China.,Institute of Health Sciences, China Medical University, Shenyang, China
| | - Xuehan Jiang
- Key Laboratory of Medical Cell Biology, Institute of Translational Medicine, China Medical University, Shenyang, China.,Institute of Health Sciences, China Medical University, Shenyang, China
| | - Huanlian Tian
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Xiaoxun Wang
- Department of Medical Oncology, the First Hospital of China Medical University, Shenyang, China
| | - Xiaoyu Song
- Key Laboratory of Medical Cell Biology, Institute of Translational Medicine, China Medical University, Shenyang, China.,Institute of Health Sciences, China Medical University, Shenyang, China
| | - Yang Yu
- Key Laboratory of Medical Cell Biology, Institute of Translational Medicine, China Medical University, Shenyang, China.,Institute of Health Sciences, China Medical University, Shenyang, China
| | - Difei Wang
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang, China
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Hu G, Liang W, Wu M, Lai C, Mei Y, Li Y, Xu J, Luo L, Quan X. Comparison of T1 Mapping and T1rho Values with Conventional Diffusion-weighted Imaging to Assess Fibrosis in a Rat Model of Unilateral Ureteral Obstruction. Acad Radiol 2019; 26:22-29. [PMID: 29705280 DOI: 10.1016/j.acra.2018.03.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/14/2018] [Accepted: 03/19/2018] [Indexed: 12/14/2022]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to investigate the potential of magnetic resonance imaging (MRI) T1 mapping and T1 relaxation time in the rotating frame (T1rho) for assessment of renal fibrosis in a rat model of unilateral ureteral obstruction (UUO). MATERIALS AND METHODS UUO was created in 36 rats. Six rats were scanned at each of the six time points (on days 0, 1, 3, 5, 10, and 15 after UUO). The contralateral kidneys were examined as controls. Hematoxylin-eosin, Masson's trichrome, and alpha-smooth muscle actin (α-SMA) antibody staining assays were performed. MRI data obtained with a 3.0T scanner were analyzed with α-SMA expression and Masson's staining. RESULTS The T1 relaxation times and T1rho values increased, and the mean apparent diffusion coefficient (ADC) values decreased with time after UUO. Simple regression analysis indicated that the mean ADCs, T1 relaxation times, and T1rho values had strong correlations with the α-SMA expression levels (R2 = 0.34, R2 = 0.66, R2 = 0.71, respectively; P< .001) and positive Masson's staining (R2 = 0.38, R2 = 0.67, R2 = 0.65, respectively; P< .001). CONCLUSIONS The T1 mapping and T1rho parameters had better correlations with α-SMA expression and Masson's staining than ADC values.
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Jiang K, Ponzo TA, Tang H, Mishra PK, Macura SI, Lerman LO. Multiparametric MRI detects longitudinal evolution of folic acid-induced nephropathy in mice. Am J Physiol Renal Physiol 2018; 315:F1252-F1260. [PMID: 30089037 DOI: 10.1152/ajprenal.00128.2018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The rodent model of folic acid (FA)-induced acute kidney injury (AKI) provides a useful model for studying human AKI, but little is known about longitudinal changes in renal hemodynamics and evolution of renal fibrosis in vivo. In this work, we aimed to longitudinally assess renal structural and functional changes using multiparametric magnetic resonance imaging (MRI). Ten adult mice were injected with FA, after which a multiparametric MRI was used to measure kidney volume, hypoxia index R2*, magnetization transfer ratio (MTR), perfusion, T1, and glomerular filtration rate (GFR) at 2 wk posttreatment. Then five mice were euthanized for histology, and the other five underwent MRI again at 4 wk, followed by histology. Control mice ( n = 5) were injected with vehicle and studied with MRI at 2 wk. Trichrome and hematoxylin-eosin staining were performed to assess FA-induced tissue injuries. Whereas kidney size and oxygenation showed progressive deterioration, a transient impairment in renal perfusion and normalized GFR slightly improved by 4 wk. Kidney fluid content, as reflected by T1, was prominent at 2 wk and tended to regress at 4 wk, consistent with observed tubular dilation. Trichrome staining revealed patchy necrosis and mild interstitial fibrosis at 2 wk, which exacerbated at 4 wk. MTR detected increased fibrosis at 4 wk. In conclusion, multiparametric MRI captured the longitudinal progression in kidney damage evolving within the first month after treatment with folic acid and may provide a useful tool for assessment of therapeutic strategies.
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Affiliation(s)
- Kai Jiang
- Division of Nephrology and Hypertension, Mayo Clinic , Rochester, Minnesota
| | - Tristan A Ponzo
- Division of Nephrology and Hypertension, Mayo Clinic , Rochester, Minnesota
| | - Hui Tang
- Division of Nephrology and Hypertension, Mayo Clinic , Rochester, Minnesota
| | - Prasanna K Mishra
- Department of Biochemistry and Molecular Biology, Mayo Clinic , Rochester, Minnesota
| | - Slobodan I Macura
- Department of Biochemistry and Molecular Biology, Mayo Clinic , Rochester, Minnesota
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic , Rochester, Minnesota
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Schley G, Jordan J, Ellmann S, Rosen S, Eckardt KU, Uder M, Willam C, Bäuerle T. Multiparametric magnetic resonance imaging of experimental chronic kidney disease: A quantitative correlation study with histology. PLoS One 2018; 13:e0200259. [PMID: 30011301 PMCID: PMC6047786 DOI: 10.1371/journal.pone.0200259] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 06/24/2018] [Indexed: 12/27/2022] Open
Abstract
Objectives In human chronic kidney disease (CKD) the extent of renal tubulointerstitial fibrosis correlates with progressive loss of renal function. However, fibrosis can so far only be assessed by histology of kidney biopsies. Magnetic resonance imaging (MRI) can provide information about tissue architecture, but its potential to assess fibrosis and inflammation in diseased kidneys remains poorly defined. Materials and methods We evaluated excised kidneys in a murine adenine-induced nephropathy model for CKD by MRI and correlated quantitative MRI parameters (T1, T2, and T2* relaxation times, apparent diffusion coefficient and fractional anisotropy) with histological hallmarks of progressive CKD, including renal fibrosis, inflammation, and microvascular rarefaction. Furthermore, we analyzed the effects of paraformaldehyde fixation on MRI parameters by comparing kidney samples before and after fixation with paraformaldehyde. Results In diseased kidneys T2 and T2* relaxation times, apparent diffusion coefficient and fractional anisotropy in the renal cortex and/or outer medulla were significantly different from those in control kidneys. In particular, T2 relaxation time was the best parameter to distinguish control and CKD groups and correlated very well with the extent of fibrosis, inflammatory infiltrates, tubular dilation, crystal deposition, and loss of peritubular capillaries and normal tubules in the renal cortex and outer medulla. Fixation with paraformaldehyde had no impact on T2 relaxation time and fractional anisotropy, whereas T1 times significantly decreased and T2* times and apparent diffusion coefficients increased in fixed kidney tissue. Conclusions MRI parameters provide a promising approach to quantitatively assess renal fibrosis and inflammation in CKD. Especially T2 relaxation time correlates well with histological features of CKD and is not influenced by paraformaldehyde fixation of kidney samples. Thus, T2 relaxation time might be a candidate parameter for non-invasive assessment of renal fibrosis in human patients.
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Affiliation(s)
- Gunnar Schley
- Department of Nephrology and Hypertension, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- * E-mail:
| | - Jutta Jordan
- Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Stephan Ellmann
- Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Seymour Rosen
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Kai-Uwe Eckardt
- Department of Nephrology and Hypertension, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
- Department of Nephrology and Medical Intensive Care, Charité –Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Uder
- Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Carsten Willam
- Department of Nephrology and Hypertension, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Tobias Bäuerle
- Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
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7
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Peperhove M, Vo Chieu VD, Jang MS, Gutberlet M, Hartung D, Tewes S, Warnecke G, Fegbeutel C, Haverich A, Gwinner W, Lehner F, Bräsen JH, Haller H, Wacker F, Gueler F, Hueper K. Assessment of acute kidney injury with T1 mapping MRI following solid organ transplantation. Eur Radiol 2017; 28:44-50. [PMID: 28710580 DOI: 10.1007/s00330-017-4943-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 04/08/2017] [Accepted: 06/09/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To evaluate T1 mapping as a non-invasive, functional MRI biomarker in patients shortly after solid organ transplantation to detect acute postsurgical kidney damage and to correlate T1 times with renal function. METHODS 101 patients within 2 weeks after solid organ transplantation (49 kidney transplantation, 52 lung transplantation) and 14 healthy volunteers were examined by MRI between July 2012 and April 2015 using the modified Look-Locker inversion recovery (MOLLI) sequence. T1 times in renal cortex and medulla and the corticomedullary difference were compared between groups using one-way ANOVA adjusted for multiple comparison with the Tukey test, and T1 times were correlated with renal function using Pearson's correlation. RESULTS Compared to healthy volunteers T1 times were significantly increased after solid organ transplantation in the renal cortex (healthy volunteers 987 ± 102 ms; kidney transplantation 1299 ± 101 ms, p < 0.001; lung transplantation 1058 ± 96 ms, p < 0.05) and to a lesser extent in the renal medulla. Accordingly, the corticomedullary difference was diminished shortly after solid organ transplantation. T1 changes were more pronounced following kidney compared to lung transplantation, were associated with the stage of renal impairment and significantly correlated with renal function. CONCLUSIONS T1 mapping may be helpful for early non-invasive assessment of acute kidney injury and renal pathology following major surgery such as solid organ transplantation. KEY POINTS • Renal cortical T1 relaxation times are prolonged after solid organ transplantation. • Cortical T1 values increase with higher stages of renal function impairment. • Corticomedullary difference decreases with higher stages of renal function impairment. • Renal cortical T1 relaxation time and corticomedullary difference correlate with renal function. • T1 mapping may be helpful for non-invasive assessment of post-operative renal pathology.
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Affiliation(s)
- Matti Peperhove
- Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Van Dai Vo Chieu
- Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Mi-Sun Jang
- Nephrology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Marcel Gutberlet
- Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Dagmar Hartung
- Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Susanne Tewes
- Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Gregor Warnecke
- Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Christiane Fegbeutel
- Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Axel Haverich
- Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Wilfried Gwinner
- Nephrology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Frank Lehner
- General, Abdominal and Transplant Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jan Hinrich Bräsen
- Pathology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Hermann Haller
- Nephrology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Frank Wacker
- Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Faikah Gueler
- Nephrology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Katja Hueper
- Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Tewes S, Gueler F, Chen R, Gutberlet M, Jang MS, Meier M, Mengel M, Hartung D, Wacker F, Rong S, Hueper K. Functional MRI for characterization of renal perfusion impairment and edema formation due to acute kidney injury in different mouse strains. PLoS One 2017; 12:e0173248. [PMID: 28319118 PMCID: PMC5358739 DOI: 10.1371/journal.pone.0173248] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/17/2017] [Indexed: 12/18/2022] Open
Abstract
Purpose The purpose was to characterize acute kidney injury (AKI) in C57BL/6 (B6)- and 129/Sv (Sv)-mice by noninvasive measurement of renal perfusion and tissue edema using functional MRI. Methods Different severities of AKI were induced in B6- and Sv-mice by renal ischemia reperfusion injury (IRI). Unilateral clamping of the renal pedicle for 35 min (moderate AKI) or 45 min (severe AKI) was done. MRI (7-Tesla) was performed 1, 7 and 28 days after surgery using a flow alternating inversion recovery (FAIR) arterial spin labeling (ASL) sequence. Maps of perfusion and T1-relaxation time were calculated. Relative MRI-parameters of the IRI kidney compared to the contralateral not-clipped kidney were compared between AKI severities and between mouse strains using unpaired t-tests. In addition, fibrosis was assessed by Masson Trichrome and collagen IV staining. Results After moderate AKI relative perfusion impairment was significantly higher in B6- than in Sv-mice at d7 (55±7% vs. 82±8%, p<0.05) and d28 (76±7% vs. 102±3%, p<0.01). T1-values increased in the early phase after AKI in both mouse strains. T1-increase was more severe after prolonged ischemia times of 45 min compared to 35 min in both mouse strains, measured in the renal cortex and outer stripe of outer medulla. Kidney volume loss (compared to the contralateral kidney) occurred already after 7 days but proceeded markedly towards 4 weeks in severe AKI. Early renal perfusion impairment was predictive for later kidney volume loss. The progression to chronic kidney disease (CKD) in the severe AKI model was similar in both mouse strains as revealed by histology. Conclusion Quantification of renal perfusion and tissue edema by functional MRI allows characterization of strain differences upon AKI. Renal perfusion impairment was stronger in B6- compared to Sv-animals following moderate AKI. Prolonged ischemia times were associated with more severe perfusion impairment and edema formation in the early phase and progression to CKD within 4 weeks of observation.
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Affiliation(s)
- Susanne Tewes
- Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- * E-mail:
| | - Faikah Gueler
- Nephrology, Hannover Medical School, Hannover, Germany
| | - Rongjun Chen
- Nephrology, Hannover Medical School, Hannover, Germany
| | - Marcel Gutberlet
- Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Mi-Sun Jang
- Nephrology, Hannover Medical School, Hannover, Germany
| | - Martin Meier
- Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Michael Mengel
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Canada
| | - Dagmar Hartung
- Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Frank Wacker
- Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Song Rong
- Nephrology, Hannover Medical School, Hannover, Germany
- The Transplantation Center of the affiliated hospital, Zunyi Medical College, Zunyi, China
| | - Katja Hueper
- Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
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Kidney Transplantation: Multiparametric Functional Magnetic Resonance Imaging for Assessment of Renal Allograft Pathophysiology in Mice. Invest Radiol 2016; 51:58-65. [PMID: 26371534 DOI: 10.1097/rli.0000000000000205] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aims of this experimental study were to investigate renal allograft pathophysiology by multiparametric functional magnetic resonance imaging (MRI) and to directly correlate MRI parameters with renal histopathology in mouse models of allogenic and isogenic kidney transplantation (ktx). MATERIALS AND METHODS Allograft rejection was induced by transplantation of C57BL/6 (B6) donor kidneys into BALB/c recipients (allogenic ktx). B6 mice that received B6 kidneys served as controls (isogenic ktx). Three weeks after ktx, MRI was performed using a 7-T small-animal scanner. Flow sensitive alternating inversion recovery echoplanar imaging arterial spin labeling, multiecho turbo spin echo, and diffusion-weighted imaging sequences were acquired. Maps of renal perfusion, T2 and T1 relaxation times, and apparent diffusion coefficients were calculated. Histological changes in the kidney were evaluated according to Banff criteria. Renal cell infiltrates and fibrosis were quantified by immunohistochemistry. Differences between groups were assessed using the Mann-Whitney U test, and the correlation of MRI parameters with renal histopathology was determined by Spearman correlation analysis. RESULTS After allogenic, but not isogenic, ktx, animals developed acute allograft rejection. Allogenic grafts were infiltrated by macrophages and T-lymphocytes and exhibited marked renal fibrosis. Magnetic resonance imaging revealed stronger impairment of renal perfusion (56 ± 7 vs 293 ± 44 mL/[min × 100 g]; P < 0.01) and more pronounced increases in T2 (60.1 ± 2.0 vs 45.7 ± 1.2 milliseconds, P < 0.01) and T1 relaxation times (1938 ± 53 vs 1350 ± 27 milliseconds, P < 0.01) in allogenic than in isogenic kidneys. Apparent diffusion coefficient was reduced to 1.39 ± 0.14 × 10(-3) mm2/s in kidneys with an acute rejection and was 1.83 ± 0.05 × 10(-3) mm2/s in isogenic kidneys without rejection (P < 0.05). Magnetic resonance imaging parameters significantly correlated with the amount of cellular infiltration and renal fibrosis observed histologically. CONCLUSIONS Functional MRI allows detection of acute renal allograft rejection after allogenic ktx in mice. Functional MRI parameters correlate with cell infiltrates and fibrosis. Thus, MRI may be used noninvasively and longitudinally to investigate mechanisms of renal allograft rejection and evaluate novel therapeutic strategies in experimental studies.
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Qian C, Yu X, Pothayee N, Dodd S, Bouraoud N, Star R, Bennett K, Koretsky A. Live nephron imaging by MRI. Am J Physiol Renal Physiol 2014; 307:F1162-8. [PMID: 25186296 DOI: 10.1152/ajprenal.00326.2014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The local sensitivity of MRI can be improved with small MR detectors placed close to regions of interest. However, to maintain such sensitivity advantage, local detectors normally need to communicate with the external amplifier through cable connections, which prevent the use of local detectors as implantable devices. Recently, an integrated wireless amplifier was developed that can efficiently amplify and broadcast locally detected signals, so that the local sensitivity was enhanced without the need for cable connections. This integrated detector enabled the live imaging of individual glomeruli using negative contrast introduced by cationized ferritin, and the live imaging of renal tubules using positive contrast introduced by gadopentetate dimeglumine. Here, we utilized the high blood flow to image individual glomeruli as hyperintense regions without any contrast agent. These hyperintense regions were identified for pixels with signal intensities higher than the local average. Addition of Mn(2+) allowed the simultaneous detection of both glomeruli and renal tubules: Mn(2+) was primarily reabsorbed by renal tubules, which would be distinguished from glomeruli due to higher enhancement in T1-weighted MRI. Dynamic studies of Mn(2+) absorption confirmed the differential absorption affinity of glomeruli and renal tubules, potentially enabling the in vivo observation of nephron function.
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Affiliation(s)
- Chunqi Qian
- Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorder and Stroke, National Institutes of Health, Bethesda, Maryland;
| | - Xin Yu
- Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorder and Stroke, National Institutes of Health, Bethesda, Maryland; High-Field Magnetic Resonance Department, Max Planck Institute for Biological Cybernetics, Tubingen, Germany
| | - Nikorn Pothayee
- Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorder and Stroke, National Institutes of Health, Bethesda, Maryland
| | - Stephen Dodd
- Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorder and Stroke, National Institutes of Health, Bethesda, Maryland
| | - Nadia Bouraoud
- Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorder and Stroke, National Institutes of Health, Bethesda, Maryland
| | - Robert Star
- Division of Kidney Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Kevin Bennett
- Department of Biology, University of Hawaii, Honolulu, Hawaii; and
| | - Alan Koretsky
- Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorder and Stroke, National Institutes of Health, Bethesda, Maryland
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Hueper K, Peperhove M, Rong S, Gerstenberg J, Mengel M, Meier M, Gutberlet M, Tewes S, Barrmeyer A, Chen R, Haller H, Wacker F, Hartung D, Gueler F. T1-mapping for assessment of ischemia-induced acute kidney injury and prediction of chronic kidney disease in mice. Eur Radiol 2014; 24:2252-60. [DOI: 10.1007/s00330-014-3250-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 04/02/2014] [Accepted: 05/15/2014] [Indexed: 12/27/2022]
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Cheng HLM, Stikov N, Ghugre NR, Wright GA. Practical medical applications of quantitative MR relaxometry. J Magn Reson Imaging 2013; 36:805-24. [PMID: 22987758 DOI: 10.1002/jmri.23718] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Conventional MR images are qualitative, and their signal intensity is dependent on several complementary contrast mechanisms that are manipulated by the MR hardware and software. In the absence of a quantitative metric for absolute interpretation of pixel signal intensities, one that is independent of scanner hardware and sequences, it is difficult to perform comparisons of MR images across subjects or longitudinally in the same subject. Quantitative relaxometry isolates the contributions of individual MR contrast mechanisms (T1, T2, T2) and provides maps, which are independent of the MR protocol and have a physical interpretation often expressed in absolute units. In addition to providing an unbiased metric for comparing MR scans, quantitative relaxometry uses the relationship between MR maps and physiology to provide a noninvasive surrogate for biopsy and histology. This study provides an overview of some promising clinical applications of quantitative relaxometry, followed by a description of the methods and challenges of acquiring accurate and precise quantitative MR maps. It concludes with three case studies of quantitative relaxometry applied to studying multiple sclerosis, liver iron, and acute myocardial infarction.
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Affiliation(s)
- Hai-Ling Margaret Cheng
- Physiology and Experimental Medicine, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
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Shah B, Anderson SW, Scalera J, Jara H, Soto JA. Quantitative MR imaging: physical principles and sequence design in abdominal imaging. Radiographics 2011; 31:867-80. [PMID: 21571662 DOI: 10.1148/rg.313105155] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Quantitative magnetic resonance (MR) imaging seeks to quantify fundamental biologic and MR-inducible tissue properties, in contrast to the routine application of MR imaging in the clinic, in which differences in MR parameters are used to generate contrast for subsequent subjective image analysis. Fundamental parameters that are commonly quantified by using MR imaging include proton density, diffusion, T1 relaxation, T2 and T2* relaxation, and magnetization transfer. Applications of these MR imaging-quantifiable parameters to abdominal imaging include oncologic imaging, evaluation of diffuse liver disease, and assessment of splenic, renal, and pancreatic disease. An understanding of the inherent physical principles underlying the basic quantitative parameters as well as the commonly used pulse sequences requisite to their derivation is critical, as this field is rapidly growing and its use will likely continue to expand in the clinic. The full potential of quantitative MR imaging applied to abdominal imaging has yet to be realized, but the myriad applications reported to date will undoubtedly continue to grow.
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Affiliation(s)
- Bhavya Shah
- Department of Radiology, Boston University Medical Center, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02218, USA
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