title: Dynamic contrast-enhanced magnetic resonance imaging measurement of renal function in patients undergoing partial nephrectomy: preliminary experience.
abstract: OBJECTIVE
  To evaluate changes in single-kidney glomerular filtration rate (SK-GFR) using low-dose dynamic contrast-enhanced magnetic resonance (MR) renography (MRR) in patients undergoing partial nephrectomy for renal masses.
  
  
  METHODS
  In this Health Information Patient Protection Act-compliant prospective study, 18 patients with renal masses underwent preoperative MR imaging at 1.5 T for renal mass evaluation and low-dose gadolinium-enhanced MRR. Magnetic resonance renography was repeated approximately 48 to 72 hours and 6 months after partial nephrectomy. Single-kidney glomerular filtration rate was calculated from the MRR images, and the right and left kidney values were summed for total MR-GFR. Postoperative changes in SK-GFR and MR-GFR were compared with changes in estimated glomerular filtration rate calculated using modification of diet in renal disease formula, renal lesion characteristics, ischemia type (warm vs cold), and ischemia time.
  
  
  RESULTS
  A decrease in the operated kidney SK-GFR was seen in 15 of the 18 patients, with a mean (SD) loss of 31% (23%), whereas estimated glomerular filtration rate decreased in 13 of the 18 patients with mean (SD) decrease of 19% (14%). Decrease in SK-GFR was greatest in the patients with warm ischemia time greater than 40 minutes and least in the patients with cold ischemia. In the immediate postoperative period, 6 of 7 patients (86%) with preoperative MR-GFR less than 60 mL/min per 1.73 m failed to demonstrate compensatory increase in SK-GFR in the nonoperated kidney, whereas 5 of 11 patients with baseline MR-GFR more than 60 mL/min per 1.73 m showed compensatory increase in nonoperated kidney SK-GFR.
  
  
  CONCLUSIONS
  Magnetic resonance renography can demonstrate functional loss in the operated kidney and compensatory increase in the function of the contralateral kidney, thus enabling evaluation of various surgical techniques on kidney function.
authors.affiliation: Department of Radiology, NYU Langone Medical Center, New York, NY 10016, USA.
authors.forename: Stella K
authors.initials: SK
authors.lastname: Kang
authors.forename: William C
authors.initials: WC
authors.lastname: Huang
authors.forename: Samson
authors.initials: S
authors.lastname: Wong
authors.forename: Jeff L
authors.initials: JL
authors.lastname: Zhang
authors.forename: Michael D
authors.initials: MD
authors.lastname: Stifelman
authors.forename: Mary T
authors.initials: MT
authors.lastname: Bruno
authors.forename: James S
authors.initials: JS
authors.lastname: Babb
authors.forename: Vivian S
authors.initials: VS
authors.lastname: Lee
authors.forename: Hersh
authors.initials: H
authors.lastname: Chandarana
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods*; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media