title: Value of dynamic MRI using the Ktrans technique for assessment of native kidneys in pre-emptive renal transplantation.
abstract: Background Different non-invasive imaging techniques such as Doppler ultrasonography and renal scintigraphy are commonly employed to assess allograft function and associated complications. However, all such methods lack sufficient specificity to discriminate between residual renal function of native kidneys. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) evaluates signal dynamics during the passage of contrast material through the renal cortex, medulla, and collecting system. Purpose To investigate the value of DCE 3T MRI using a quantitative pharmacokinetic parameter (Ktrans) for the assessment of native kidneys before and after pre-emptive renal transplantation. Material and Methods Twenty-five consecutive patients with end-stage renal disease underwent DCE MRI before and 6 months after kidney transplantation. MRI was performed using a 3T scanner. Regions of interests were drawn over each kidney, encompassing the cortex and medulla but excluding the collecting system and any coexisting cysts. Parametric Ktrans values were automatically generated. Results In the pre-transplantation group, mean Ktrans values for the right and left kidneys were 0.55 ± 0.09 min-1and 0.44 ± 0.15 min-1, respectively. In the post-transplantation group, mean Ktrans values of the right and left kidneys were 0.27 ± 0.07 min-1and 0.25 ± 0.10 min-1, respectively. There were statistically significant differences between right and left kidneys in terms of mean Ktrans values in the pre- and post-transplantation groups ( P < 0.001). Conclusion Our preliminary results show that native kidneys were still functioning 6 months after transplantation. MR perfusion using Ktrans may constitute a non-invasive means of determination of the viability of native kidneys after renal transplantation.
authors.affiliation: 1 AtaturkUniversity, School of Medicine, Department of Radiology, Erzurum, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Sade
authors.affiliation: 1 AtaturkUniversity, School of Medicine, Department of Radiology, Erzurum, Turkey.
authors.forename: Mecit
authors.initials: M
authors.lastname: Kantarci
authors.affiliation: 1 AtaturkUniversity, School of Medicine, Department of Radiology, Erzurum, Turkey.
authors.forename: Leyla
authors.initials: L
authors.lastname: Karaca
authors.affiliation: 2 Bozok University, School of Medicine, Department of Radiology, Yozgat, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Okur
authors.affiliation: 1 AtaturkUniversity, School of Medicine, Department of Radiology, Erzurum, Turkey.
authors.forename: Hayri
authors.initials: H
authors.lastname: Ogul
authors.affiliation: 3 AtaturkUniversity, School of Medicine, Department of Internal Medicine, Division of Nephrology, Erzurum, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Keles
authors.affiliation: 3 AtaturkUniversity, School of Medicine, Department of Internal Medicine, Division of Nephrology, Erzurum, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Çankaya
authors.affiliation: 4 AtaturkUniversity, School of Medicine, Department of Nuclear Medicine, Erzurum, Turkey.
authors.forename: Arif Kursad
authors.initials: AK
authors.lastname: Ayan
mesh_terms: D000328:Adult; D003287:Contrast Media / Q000493:pharmacokinetics*; D005260:Female; D019786:Gadolinium DTPA / Q000493:pharmacokinetics*; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Diagnostic imaging; glomerular filtration rate; kidney transplantation; magnetic resonance imaging (MRI)