Magnetic Resonance Imaging Assessment of Kidney Oxygenation and Perfusion During Sickle Cell Vaso-occlusive Crises
| Autor: | Bertrand Godeau, Pablo Bartolucci, Etienne Audureau, Elena-Maria Manea, Constance Guillaud-Danis, Philippe Lang, Anoosha Habibi, Pierre Brugières, Jean-François Deux, Vincent Audard, Thomas Stehlé, Philippe Grimbert, Frédéric Galactéros, Alain Rahmouni |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Adult Male congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Pathology 030232 urology & nephrology Renal function Pilot Projects Anemia Sickle Cell Kidney Sickle cell nephropathy 03 medical and health sciences chemistry.chemical_compound Young Adult 0302 clinical medicine hemic and lymphatic diseases Internal medicine medicine Humans Intravoxel incoherent motion Creatinine medicine.diagnostic_test business.industry Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging Oxygen 030104 developmental biology chemistry Nephrology Regional Blood Flow Case-Control Studies Cardiology Albuminuria Female medicine.symptom business Perfusion Kidney disease |
| Zdroj: | American journal of kidney diseases : the official journal of the National Kidney Foundation. 69(1) |
| ISSN: | 1523-6838 |
| Popis: | Background Our understanding of the pathophysiologic processes underlying sickle cell nephropathy remains incomplete. We performed a pilot study to investigate the potential value of magnetic resonance imaging (MRI) for the assessment of kidney oxygenation and detection of potential changes to tissue perfusion and cellular integrity during a vaso-occlusive crisis. Study Design A case-control study. Setting & Participants 10 homozygous patients with sickle cell disease (SCD), without kidney disease (based on estimated glomerular filtration rate and albuminuria), underwent renal MRI during a vaso-occlusive crisis episode. The imaging data obtained were compared with those for a second MRI performed at steady state (median, 56 [IQR, 37-72] days after the vaso-occlusive crisis MRI). The control group consisted of 10 apparently healthy individuals. Measurements Deoxyhemoglobin level assessed by R2* value was calculated using the blood oxygen level−dependent technique. The intravoxel incoherent motion diffusion-weighted imaging technique was used to calculate D, D*, and F parameters. Results Median medullary R2* values on steady-state MRI were significantly higher for patients with SCD than for controls ( P =0.01) and did not change significantly during the vaso-occlusive crisis. No significant differences in median cortical R2* values were observed. Both cellular integrity (D) and local perfusion (D* and F) were significantly altered in medullary and cortical areas during vaso-occlusive crises in comparison to steady state in patients with SCD. These parameters did not differ significantly between patients with SCD assessed at steady state and the control group. Limitations Small sample size, estimation of glomerular filtration rate according to CKD-EPI creatinine equation without adjustment for race. Conclusions Deoxyhemoglobin levels in the medullary area are higher in patients with SCD, during vaso-occlusive crises and at steady state, than in controls. Alterations to the tissue perfusion and cellular integrity of renal parenchyma are a common finding during vaso-occlusive crises that provide additional evidence that a vaso-occlusive crisis may be associated with subclinical kidney injury detectable on MRI. |
| Databáze: | OpenAIRE |
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