title: MRI for the assessment of organ perfusion in patients with chronic kidney disease.
abstract: OBJECTIVE
  Recent data have highlighted the importance of quantitative measures of organ perfusion and functional reserve. Magnetic resonance imaging allows the assessment of markers of perfusion without the use of contrast media. Techniques such as arterial spin labelling (ASL) and blood oxygen level-dependent (BOLD) imaging have been available for some time, but advances in the technology and concerns over the safety of contrast media in renal disease have spurred renewed interest and development.
  
  
  RESULTS
  ASL measures perfusion, whereas BOLD imaging provides a marker of blood oxygenation, arising from the compound effect of a number of measures including perfusion, blood volume and oxygen consumption; thus, the techniques are complementary rather than analogous. They were initially confined to brain imaging as inherently low signal, susceptibility effects and motion limited their use in thoracic and abdominal organs. Advances in technology have led to robust sequences that can quantify clinically relevant changes and correlate well with reference standards. Novel approaches are likely to accelerate translation into clinical practice.
  
  
  CONCLUSIONS
  The noninvasive and repeatable nature of ASL and BOLD imaging makes it likely that they will be increasingly used in clinical research. Using a developmental framework, we suggest that the application of these techniques to thoracic and abdominal organs requires validation before they are suitable for generalized clinical use. The demand for these techniques is likely to be driven by the incentive to avoid the use of contrast media.
authors.affiliation: School of Graduate Entry Medicine and Health, University of Nottingham, Nottingham, UK.
authors.forename: Aghogho
authors.initials: A
authors.lastname: Odudu
authors.forename: Susan T
authors.initials: ST
authors.lastname: Francis
authors.forename: Christopher W
authors.initials: CW
authors.lastname: McIntyre
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D001810:Blood Volume; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D055420:Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D012079:Renal Circulation; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D013113:Spin Labels
chemical_list: D015415:Biomarkers; D013113:Spin Labels; D010100:Oxygen