Noninvasive evaluation of intrarenal oxygenation with BOLD MRI
Prasad, P.V.; Edelman, R.R.; Epstein, F.H.
Circulation 94(12): 3271-3275
1996
ISSN/ISBN: 0009-7322 PMID: 8989140 Document Number: 458448
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 in- duce diuresis were studied. Spin-spin relaxation rate, R-2*, Was measured, which is directly related to the amount of deoxyhemoglobin in blood and in turn to tissue PO-2. Furosemide but not acetazolamide (n=6 each) increased medullary oxygenation (DELTA-R-2*=7.62 Hz; P lt .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 (DELTA-R-2*=6.43 Hz; P lt .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.