Simultaneous evaluation of renal morphology and function in live kidney donors using dynamic magnetic resonance imaging.
BACKGROUND
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Artunc
F
F
Department of Internal Medicine IV, Section of Nephrology and Hypertension, University of Tübingen, Otfried-Mueller-Str. 10, 72076 Tübingen, Germany. ferruh.artunc@med.uni-tuebingen.de
Yildiz
S
S
Rossi
C
C
Boss
A
A
Dittmann
H
H
Schlemmer
H P
HP
Risler
T
T
Heyne
N
N
D000328:Adult; D003404:Creatinine / Q000378:metabolism; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000033:anatomy & histology* / Q000098:blood supply / Q000000981:diagnostic imaging / Q000502:physiology*; D007677:Kidney Function Tests / Q000379:methods* / Q000706:statistics & numerical data; D016030:Kidney Transplantation; D019520:Living Donors; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate
D019275:Radiopharmaceuticals; D003404:Creatinine; D016284:Technetium Tc 99m Pentetate