Structural and functional MRI in children with renal disease: first experience.
OBJECTIVE
This MRI study demonstrates our first clinical experiences with structural and functional evaluation in children with renal dysfunction, and communicates our experience with quantitative measurements of renal function compared to reference values found employing radionucleotides.


METHODS
We included renal impaired children who were recruited for clinical radioisotopic GFR measurements (n=8). MRI was performed 2 hours after Cr-EDTA measurements and was conducted using a protocol involving both anatomical/structural sequences and a dynamic contrast-enhanced sequence. Data obtained with the dynamic MRI sequence were processed using the graphical Patlak approach to obtain estimates of GFR.


RESULTS
We were able to characterize the intrarenal configuration (cortex, medulla, pelvicalyceal arrangement) in all cases. Functional analyses of dynamic contrast-enhanced MRI revealed an overall underestimation of GFR measured by MRI compared to Cr-EDTPA measures (range: -2% to -43%).


CONCLUSIONS
We advocate the use of MRI as a single-modality approach in the structural and functional evaluation of impaired kidneys in children, and concurrently, we presented a clinically available strategy for estimations of renal cortical volume and single kidney function. However, the use of MRI contrast agents have recently become controversial in renal patients due to the risk of NSF.
Jørgensen
Bettina
B
Institute of Clinical Medicine, Aarhus University Hospital, Denmark.
Karstoft
Kristian
K
Jørgensen
Troels Munch
TM
Rittig
Søren
S
Frøkiaer
Jørgen
J
Pedersen
Michael
M
D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D004492:Edetic Acid; D005260:Female; D005682:Gadolinium; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000033:anatomy & histology / Q000503:physiopathology*; D007674:Kidney Diseases / Q000503:physiopathology*; D007677:Kidney Function Tests / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male
D004492:Edetic Acid; D005682:Gadolinium