Department of Internal Medicine IV, Section of Nephrology and Hypertension, University of Tübingen, Otfried-Mueller-Str. 10, 72076 Tübingen, Germany.
Nephrol Dial Transplant. 2010 Jun;25(6):1986-91. doi: 10.1093/ndt/gfp772. Epub 2010 Jan 25.
Evaluation of potential kidney donors requires the assessment of both kidney anatomy and function. In this prospective study, we sought to expand the diagnostic yield of magnetic resonance (MR) by adding functional measurements of glomerular filtration rate (GFR) and split renal function.
Between 2007 and 2009, all potential kidney donors presenting to our facility underwent a comprehensive single-stop MR study that included an assessment of anatomy, angiography and functional measurements. GFR was measured after a bolus injection of gadobutrol (4 ml, approximately 0.05 mmol/kg) and calculated from the washout of the signal intensity obtained over the liver. Split renal function was calculated from the increase of signal intensity over the renal cortex. Values were compared to renal scintigraphy with (99m)Tc-DTPA from the same day.
The MR investigation was successfully performed in 21 participants. The GFR derived from MR (MR-GFR) correlated well (r = 0.84) with the GFR derived from scintigraphy (DTPA-GFR). The mean value of the paired differences was 4 +/- 13 [SD] ml/min/1.73 m(2) and was not significantly different from zero. The ratio between right and left kidney function was similar with both techniques (1.01 +/- 0.17 with MR and 1.06 +/- 0.12 with scintigraphy, P = 0.20).
We demonstrate an MR-based approach to comprehensively evaluate both kidney anatomy and function in a single investigation, thereby facilitating the evaluation of potential kidney donors.
评估潜在的肾脏捐献者需要评估肾脏解剖结构和功能。在这项前瞻性研究中，我们试图通过添加肾小球滤过率（GFR）和分肾功能的功能测量来扩大磁共振（MR）的诊断效果。
在 2007 年至 2009 年间，所有到我们机构的潜在肾脏捐献者都接受了全面的一站式 MR 研究，该研究包括解剖评估、血管造影和功能测量。GFR 是在注射钆布醇（4ml，约 0.05mmol/kg）后通过测量肝脏信号强度的洗脱来测量的。分肾功能是通过测量肾皮质信号强度的增加来计算的。这些值与当天的（99m）Tc-DTPA 肾闪烁扫描进行了比较。
21 名参与者成功完成了 MR 检查。从 MR 得出的 GFR（MR-GFR）与从闪烁扫描得出的 GFR（DTPA-GFR）相关性良好（r=0.84）。配对差值的平均值为 4+/-13[SD]ml/min/1.73m（2），与零值无显著差异。两种技术的右肾和左肾功能比值相似（MR 为 1.01+/-0.17，闪烁扫描为 1.06+/-0.12，P=0.20）。
我们展示了一种基于 MR 的方法，可以在一次检查中全面评估肾脏解剖结构和功能，从而有助于潜在肾脏捐献者的评估。
