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Quantitative evaluation of acute renal transplant dysfunction with low-dose three-dimensional MR renography.

Publication ,  Journal Article
Yamamoto, A; Zhang, JL; Rusinek, H; Chandarana, H; Vivier, P-H; Babb, JS; Diflo, T; John, DG; Benstein, JA; Barisoni, L; Stoffel, DR; Lee, VS
Published in: Radiology
September 2011

PURPOSE: To assess prospectively the ability of quantitative low-dose three-dimensional magnetic resonance (MR) renography to help identify the cause of acute graft dysfunction. MATERIALS AND METHODS: This HIPAA-compliant study was approved by the institutional review board, and written informed consent was obtained. Between December 2001 and May 2009, sixty patients with transplanted kidneys (41 men and 19 women; mean age, 49 years; age range, 22-71 years) were included. Thirty-one patients had normal function and 29 had acute dysfunction due to acute rejection (n = 12), acute tubular necrosis (ATN) (n = 8), chronic rejection (n = 6), or drug toxicity (n = 3). MR renography was performed at 1.5 T with three-dimensional gradient-echo imaging. With use of a multicompartment renal model, the glomerular filtration rate (GFR) and the mean transit time (MTT) of the tracer for the vascular compartment (MTT(A)), the tubular compartment (MTT(T)), and the collecting system compartment (MTT(C)) were calculated. Also derived was MTT for the whole kidney (MTT(K) = MTT(A) + MTT(T) + MTT(C)) and fractional MTT of each compartment (MTT(A/K) = MTT(A)/MTT(K), MTT(T/K) = MTT(T)/MTT(K), MTT(C/K) = MTT(C)/MTT(K)). These parameters were compared in patients in the different study groups. Statistical analysis was performed by using analysis of covariance. RESULTS: There were significant differences in GFR and MTT(K) between the acute dysfunction group (36.4 mL/min ± 20.8 [standard deviation] and 177.1 seconds ± 46.8, respectively) and the normal function group (65.9 mL/min ± 27.6 and 140.5 seconds ± 51.8, respectively) (P < .001 and P = .004). The MTT(A/K) was significantly higher in the acute rejection group (mean, 12.7% ± 2.9) than in the normal function group (mean, 8.3% ± 2.2; P < .001) or in the ATN group (mean, 7.1% ± 1.4; P < .001). The MTT(T/K) was significantly higher in the ATN group (mean, 83.2% ± 9.2) than in the normal function group (mean, 72.4% ± 10.2; P = .031) or in the acute rejection group (mean, 69.2% ± 6.1; P = .003). CONCLUSION: Low-dose MR renography analyzed by using a multicompartmental tracer kinetic renal model may help to differentiate noninvasively between acute rejection and ATN after kidney transplantation.

Duke Scholars

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Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

September 2011

Volume

260

Issue

3

Start / End Page

781 / 789

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Failure
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Radioisotope Renography
  • Radiation Dosage
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Magnetic Resonance Imaging
  • Kidney Transplantation
 

Citation

APA
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ICMJE
MLA
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Yamamoto, A., Zhang, J. L., Rusinek, H., Chandarana, H., Vivier, P.-H., Babb, J. S., … Lee, V. S. (2011). Quantitative evaluation of acute renal transplant dysfunction with low-dose three-dimensional MR renography. Radiology, 260(3), 781–789. https://doi.org/10.1148/radiol.11101664
Yamamoto, Akira, Jeff L. Zhang, Henry Rusinek, Hersh Chandarana, Pierre-Hugues Vivier, James S. Babb, Thomas Diflo, et al. “Quantitative evaluation of acute renal transplant dysfunction with low-dose three-dimensional MR renography.Radiology 260, no. 3 (September 2011): 781–89. https://doi.org/10.1148/radiol.11101664.
Yamamoto A, Zhang JL, Rusinek H, Chandarana H, Vivier P-H, Babb JS, et al. Quantitative evaluation of acute renal transplant dysfunction with low-dose three-dimensional MR renography. Radiology. 2011 Sep;260(3):781–9.
Yamamoto, Akira, et al. “Quantitative evaluation of acute renal transplant dysfunction with low-dose three-dimensional MR renography.Radiology, vol. 260, no. 3, Sept. 2011, pp. 781–89. Pubmed, doi:10.1148/radiol.11101664.
Yamamoto A, Zhang JL, Rusinek H, Chandarana H, Vivier P-H, Babb JS, Diflo T, John DG, Benstein JA, Barisoni L, Stoffel DR, Lee VS. Quantitative evaluation of acute renal transplant dysfunction with low-dose three-dimensional MR renography. Radiology. 2011 Sep;260(3):781–789.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

September 2011

Volume

260

Issue

3

Start / End Page

781 / 789

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Failure
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Radioisotope Renography
  • Radiation Dosage
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Magnetic Resonance Imaging
  • Kidney Transplantation