(Circulation. 1996;94:3271-3275.)
© 1996 American Heart Association, Inc.
Articles |
Noninvasive Evaluation of Intrarenal Oxygenation With BOLD MRI
the Departments of Radiology and Medicine (F.H.E.), Beth Israel Hospital and Harvard Medical School, Boston, Mass.
Correspondence to P.V. Prasad, PhD, Department of Radiology, MRI (Room AN-242), Beth Israel Hospital, 330 Brookline Ave, Boston, MA 02215. E-mail pprasad@bidmc.harvard.edu.
Background The countercurrent arrangement of capillary blood flow in the medulla of mammalian kidneys generates a gradient of oxygen tension between the renal cortex and the papillary tip that results in a state of relative hypoxia within the renal medulla. Exploration of the pathophysiological implications of medullary hypoxia has been hampered by the absence of a noninvasive technique to estimate intrarenal oxygenation in different zones of the kidney. In the present study, we demonstrate the feasibility of such a method on the basis of blood oxygenation level–dependent (BOLD) MRI, which allows sequential measurements in humans in response to a variety of physiological/pharmacological stimuli in health and disease.
Methods and Results BOLD MRI measurements were obtained in healthy young human subjects (n=7), and the effects of three different pharmacological/physiological maneuvers that induce diuresis were studied. Spin-spin relaxation rate, R2*, was measured, which is directly related to the amount of deoxyhemoglobin in blood and in turn to tissue PO2. Furosemide but not acetazolamide (n=6 each) increased medullary oxygenation (
R2*=7.62 Hz; P<.01), consistent with the separate sites of action of these diuretics in the nephron and with previous direct measurements of their effects in anesthetized rats with oxygen microelectrodes. A new finding is that water diuresis improves medullary oxygenation (R2*=6.43 Hz; P<.01) in young human subjects (n=5).
Conclusions BOLD MRI can be used to monitor changes in intrarenal oxygenation in humans in a noninvasive fashion.
Key Words: magnetic resonance imaging • kidney • blood flow • oxygen • hypoxia
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