title: Contrast-enhanced CT imaging in patients with chronic kidney disease.
abstract: Renal microvascular rarefaction characterizes chronic kidney disease (CKD). In murine models of CKD, micro-CT imaging reflected capillary rarefaction using quantification of renal relative blood volume (rBV). In addition, micro-CT imaging revealed morphological alterations of the intrarenal vasculature including reduced vascular branching and lumen diameter. Here, we retrospectively quantified rBV in contrast-enhanced CT angiography in patients and found that, compared to non-CKD patients, those with CKD and renal fibrosis had significantly reduced rBV in the renal cortex. rBV values closely mirrored capillary rarefaction in the corresponding nephrectomy specimens. In patients with follow-up CT angiography, reduction of renal function was paralleled by a decline in rBV. Using virtual autopsy, i.e., postmortem CT angiography, morphometry of intrarenal arteries in 3D-rendered CT images revealed significantly reduced arterial diameter and branching in CKD compared to non-CKD cases. In conclusion, in CKD patients, contrast-enhanced CT imaging with quantification of rBV correlates with functional renal vasculature, whereas virtual autopsy allows morphometric analyses of macrovascular changes. Importantly, the observed vascular alterations in CKD patients mirror those in animals with progressive CKD, suggesting a high relevance of animal models for studying vascular alterations in CKD and renal fibrosis.
authors: Institute of Pathology, Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany.
authors: Saskia
authors: S
authors: von Stillfried
authors: Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Aachen, Germany.|Department of Diagnostic and Interventional Radiology, University Hospital, Philipps University Marburg, Marburg, Germany.
authors: Jonas C
authors: JC
authors: Apitzsch
authors: Department of Experimental Molecular Imaging, University Clinic and Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany.
authors: Josef
authors: J
authors: Ehling
authors: Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Aachen, Germany.
authors: Tobias
authors: T
authors: Penzkofer
authors: Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Aachen, Germany.|Department of Diagnostic and Interventional Radiology, University Hospital, Philipps University Marburg, Marburg, Germany.
authors: Andreas H
authors: AH
authors: Mahnken
authors: Institute of Pathology, Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany.
authors: Ruth
authors: R
authors: Knüchel
authors: Department of Nephrology, RWTH Aachen University Hospital, Aachen, Germany.
authors: Jürgen
authors: J
authors: Floege
authors: Institute of Pathology, Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany. pboor@ukaachen.de.|Department of Nephrology, RWTH Aachen University Hospital, Aachen, Germany. pboor@ukaachen.de.
authors: Peter
authors: 0000-0001-9921-4284
authors: P
authors: Boor
mesh_terms: D000368:Aged; D000818:Animals; D001810:Blood Volume; D002196:Capillaries / Q000000981:diagnostic imaging / Q000473:pathology; D015331:Cohort Studies; D000072226:Computed Tomography Angiography / Q000379:methods*; D003287:Contrast Media; D018450:Disease Progression; D005355:Fibrosis; D006801:Humans; D021621:Imaging, Three-Dimensional; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D012079:Renal Circulation; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media
keywords: Capillary rarefaction; Microvasculature; Non-invasive imaging; Progression of kidney disease; Relative renal blood volume; Renal fibrosis