UDC: 616.61-072.7
BBC: 53.642
Shkuratova Yu.Yu., Morozova T.G.
Justification of Performing Magnetic Resonance Imaging of the Kidneys in Patients in Critical Conditions
Keywords: diffusion-weighted images, ASL perfusion, magnetic resonance imaging, acute kidney injury, acute renal failure
Acute kidney injury is a serious problem in intensive care and healthcare in general. The aim of the study is to determine the opportunities and justify the expediency of performing diffusion–weighted images and ASL-perfusion in assessing morphofunctional renal disorders in patients in critical conditions. Material and methods. 101 patients diagnosed with acute kidney injury on the basis of the RSFHF «City Clinical Hospital № 1» (the town of Smolensk) had magnetic resonance imaging of the kidneys and retroperitoneal organs performed using diffusion-weighted images and ASL-perfusion. The data obtained from the autopsy kidney material of deceased patients (n = 32) were compared with the lifetime indicators of diffusion-weighted images and ASL-perfusion. The control group consisted of 54 volunteers without pathology of the genitourinary system. Results. According to the results of magnetic resonance imaging, all patients were divided into three groups. Group 1 (n = 48) included patients with the following results: there was no qualitative restriction of diffusion, the measured diffusion coefficient was = 1.89–2.1´10– 3 mm2/s, ASL-perfusion was ≤ 469 ml/100g/min. In the 2nd group (n = 31), the following results were obtained: qualitatively – there was no restriction of diffusion, the measured diffusion coefficient was = 1.89–2.1´10-3 mm2/s, ASL-perfusion was ≥ 470 ml/100g/min. In the 3rd group (n = 22), the presence of diffusion restriction was noted, the measured diffusion coefficient was < 1.79´10-3 mm2/s. ASL-perfusion was not required in this group of patients, the results were false positive. Conclusions. Magnetic resonance imaging of the kidneys using diffusion-weighted images and ASL-perfusion makes it possible to determine morphofunctional renal disorders without the use of invasive techniques, as well as to predict the outcome in each group of patients.
References
- Аrapova O.V., Rodionov V.V., Shutov A.M. Problema rannei diagnostiki ostrogo povrejdeniya pochek u onkologicheskih bolnyh [The problem of early diagnosis of acute kidney injury in cancer patients]. Ulyanovsky meditsynsky I biologichesky jurnal, 2014, no.1, pp. 24–
- Evseev A.N. Patent na izobretenie RU 2 231 298. Neinvazivnyi sposob prognozirovaniya razryvov pochek pri gemorragicheskoi lihoradke s pochechnym syndromom [Non-invasive method for predicting renal ruptures in hemorrhagic fever with renal syndrome]. Patent RF, no. 2 231298, 2004.
- Shanin V. Y . Patophysyologiya kriticheskyh sostoyanyi [The pathophysiology of kritikal illness]. 3rd St. Petersburg, 2021, 440 p.
- Carol A., Shneider M., Friedli I. Diffusion-weighted magnetic resonance imaging to assess diffuse renal pathology: a systematic review and statement paper. Nephrol Dial Transplant, 2018. vol. 33, pp.29– DOI: 10.1093/ndt/gfy163.
- Hueper K., Rong S., Gutberlet M. et al. T2 relaxation time and apparent diffusion coefficient for noninvasive assessment of renal pathology after acute kidney injury in mice: comparison with histopathology. Invest Radiol., 2013, vol. 12, pp. 834–842. DOI: 10.1097/RLI.0b013e31829d0414.
- KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group, Kidney inter, 2012, 138 p.
- Łagosz P., Biegus J., Urban S., Zymliński R. Renal Assessment in Acute Cardiorenal Syndrome. Biomolecules, 2023, vol. 2. DOI: 10.3390/biom13020239.
- Mukherjee S., Bhaduri S., Harwood R., Murray P. et al. Multiparametric MRI based assessment of kidney injury in a mouse model of ischemia reperfusion injury. Sci Rep., vol. 14, p. 19922. DOI: 10.1038/s41598-024-70401-x.
- Srisavat N., Hoste E., Kellum J. Modern classification of acute kidney injury. Blood purification, 2010, vol. 29, pp. 300–307. DOI: 10.1159/000280099.
- Susantitaphong P., Cruz DN., Cerda J. et al. Acute Kidney Injury Advisory Group of the American Society of Nephrology. World incidence of AKI: a meta-analysis. Clin J Am Soc Nephrol., 2013, vol. 8, pp. 1482–1493. DOI: 2215/CJN.00710113.
- Wilson FP., Shashaty M., Testani J. et al. Automated electronic alerts for acute kidney injury: a single-blind, parallel-group, randomized controlled trial. Lancet, vol. 385, pp. 1966–1974. DOI: 10.1016/S0140-6736(15)60266-5.
- Zhiyan F., Jiamei J., Chen X. et al. Construction and validation of prognostic models in critically Ill patients with sepsis-associated acute kidney injury: interpretable machine learning approach. Journal of Translational Medicine, 2023. vol. 21. DOI: 1186/s12967-023-04205-4.
About authors
- Shkuratova Yuliya Yu.
- Post-Graduate Student, Department of Radiation Diagnostics and Radiation Therapy with a course of Additional Professional Education, Smolensk State Medical University, Russia, Smolensk (juliyamilosh@yandex.ru; ORCID: https://orcid.org/0009-0000-0153-6040)
- Morozova Tatiana G.
- Head of the Department of Radiation Diagnostics and Radiation Therapy with a course of Additional Professional Education, Smolensk State Medical University, Russia, Smolensk (t.g.morozova@yandex.ru; ORCID: https://orcid.org/0000-0003-4983-5300)
Article link
Shkuratova Yu.Yu., Morozova T.G. Justification of Performing Magnetic Resonance Imaging of the Kidneys in Patients in Critical Conditions [Electronic resource] // Acta medica Eurasica. – 2024. – №4. P. 14-21. – URL: https://acta-medica-eurasica.ru/en/single/2024/4/2/. DOI: 10.47026/2413-4864-2024-4-14-21.