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Comparing Kidney Perfusion Using Noncontrast Arterial Spin Labeling MRI and Microsphere Methods in an Interventional Swine Model

Artz, Nathan S. MS*; Wentland, Andrew L. BS*; Sadowski, Elizabeth A. MD†; Djamali, Arjang MS, MD‡; Grist, Thomas M. MD*†; Seo, Songwon MS§; Fain, Sean B. PhD*†

doi: 10.1097/RLI.0b013e3181f5e101
Original Article

Objective: The purpose of this study was to assess the ability of a flow-sensitive alternating inversion recovery–arterial spin labeling (FAIR-ASL) technique to track renal perfusion changes during pharmacologic and physiologic alterations in renal blood flow using microspheres as a gold standard.

Materials and Methods: Fluorescent microsphere and FAIR-ASL perfusion were compared in the cortex of the kidney for 11 swine across 4 interventional time points: (1) under baseline conditions, (2) during an acetylcholine and fluid bolus challenge to increase perfusion, (3) initially after switching to isoflurane anesthesia, and (4) after 2 hours of isoflurane anesthesia. In 10 of the 11 swine, a bag of ice was placed on the hilum of 1 kidney at the beginning of isoflurane administration to further reduce perfusion in 1 kidney.

Results: Both ASL and microspheres tracked the expected cortical perfusion changes (P < 0.02) across the interventions, including an increase in perfusion during the acetylcholine challenge and decrease during the administration of isoflurane. Both techniques also measured lower cortical perfusion in the iced compared with the noniced kidneys (P ≤ 0.01). The ASL values were systematically lower compared with microsphere perfusion. Very good correlation (r = 0.81, P < 0.0001) was observed between the techniques, and the relationship appeared linear for perfusion values in the expected physiologic range (microsphere perfusion <550 mL/min/100 g) although ASL values saturated for perfusion >550 mL/min/100 g.

Conclusion: Cortical perfusion measured with ASL correlated with microspheres and reliably detected changes in renal perfusion in response to physiologic challenge.

From the *Departments of Medical Physics, †Radiology, ‡Nephrology, and §Biostatistics and Medical Informatics, Wisconsin Institute for Medical Research, University of Wisconsin – Madison, Madison, WI.

Received March 5, 2010; accepted for publication (after revision) July 18, 2010.

Supported by internal department research funds, Society of Uroradiology, and the National Institute of Health (NIH grants R01 DK073680, R21 DK070243).

Reprints: Sean B. Fain, PhD, Department of Medical Physics, Wisconsin Institutes for Medical Research, 1111 Highland Ave, Madison, WI 53705. E-mail: sfain@wisc.edu.

© 2011 Lippincott Williams & Wilkins, Inc.