Evaluation of Renal Oxygenation and Hemodynamics in Patients with Chronic Kidney Disease by Blood Oxygenation Level-dependent Magnetic Resonance Imaging and Intrarenal Doppler Ultrasonography

Nephron ◽  
2021 ◽  
pp. 1-11
Author(s):  
Jing Yang ◽  
Shuohui Yang ◽  
Yizeng Xu ◽  
Fang Lu ◽  
Lan You ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Doppler Ultrasonography ◽  
Blood Oxygenation Level Dependent ◽  
Blood Oxygenation ◽  
Resonance Imaging ◽  
Clinical Indicators ◽  
Bold Mri ◽  
Kidney Length ◽  
Blood Oxygenation Level ◽  
Oxygenation Level

<b><i>Introduction:</i></b> The basic pathophysiologic derangement of chronic kidney disease (CKD) begins with the loss of nephrons, leading to renal hemodynamic changes, eventually causing a reduced nephron count and renal hypoxia. The purpose of this study was to observe the renal oxygenation and renal hemodynamics of patients with CKD using blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) and intrarenal Doppler ultrasonography (IDU). <b><i>Methods:</i></b> The study enrolled 39 patients with stage 1–4 CKD and 19 healthy volunteers (HVs). Based on their estimated glomerular filtration rate (eGFR), CKD patients were divided into 2 subgroups: a mild renal impairment (MI) group and a moderate to severe renal impairment (MSI) group. We monitored the participants’ mean cortical T2* (COT2*) and mean medullary T2* (MET2*) values on BOLD-MRI, and measured the peak systolic velocities (PSVs), end-diastolic velocities (EDVs), renal resistive index (RI), and kidney length by IDU. We also recorded clinical indicators such as age, sex, body mass index (BMI), 24-h urinary protein (24-h Upr), serum creatinine (sCr), blood urea nitrogen (BUN), and eGFR. BOLD-MRI, IDU measurements, and the clinical indicators were compared in CKD patients and HVs by the analysis of variance and Kruskal-Wallis <i>H</i> test. Spearman’s correlation was used to assess the relationship between data from BOLD-MRI and IDU and clinical indicators. <b><i>Results:</i></b> The COT2* values were significantly higher than the MET2* values in the HV, MI, and MSI groups. COT2*, MET2*, EDV, PSV, and kidney length gradually decreased in the HV, MI, and MSI groups (all <i>p &#x3c;</i> 0.05), whereas RI and 24-h Upr gradually increased (both <i>p</i> &#x3c; 0.05). Spearman correlation analysis showed that COT2* and MET2* were significantly positively correlated with eGFR, PSV, EDV, and kidney length but were significantly negatively correlated with sCr, BUN, and 24-h Upr (all <i>p</i> &#x3c; 0.05). There was no correlation observed between the COT2* and MET2* and the RI and BMI values. <b><i>Conclusions:</i></b> Renal oxygenation and blood flow velocities were found declined as the CKD stage progressed. The BOLD-MRI and IDU techniques may have clinical value by measuring intrarenal oxygenation and renal blood perfusion to judge the severity of renal damage in patients with CKD.

Attenuated Brain Response to Auditory Word Stimulation with Sevoflurane

2005 ◽  
Vol 103 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Chantal Kerssens ◽  
Stephan Hamann ◽  
Scott Peltier ◽  
Xiaoping P. Hu ◽  
Michael G. Byas-Smith ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Occipital Cortex ◽  
Blood Oxygenation Level Dependent ◽  
Blood Oxygenation ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Brain Response ◽  
Auditory Word ◽  
Blood Oxygenation Level ◽  
Oxygenation Level

Background Functional magnetic resonance imaging offers a compelling, new perspective on altered brain function but is sparsely used in studies of anesthetic effect. To examine effects on verbal memory encoding, the authors imaged human brain response to auditory word stimulation using functional magnetic resonance imaging at different concentrations of an agent not previously studied, and tested memory after recovery. Methods Six male volunteers were studied breathing 0.0, 2.0, and 1.0% end-tidal sevoflurane (awake, deep, and light states, respectively) via laryngeal mask. In each condition, they heard 15 two-syllable English nouns via closed headphones. Each word was repeated 15 times (1/s), followed by 15 s of rest. Blood oxygenation level-dependent brain activations during blocks of stimulation versus rest were assessed with a 3-T Siemens Trio scanner and a 20-voxel spatial extent threshold. Memory was tested approximately 1.5 h after recovery with an auditory recognition task (chance performance = 33% correct). Results Scans showed widespread activations (P &lt; 0.005, uncorrected) in the awake state, including bilateral superior temporal, frontal, and parietal cortex, right occipital cortex, bilateral thalamus, striatum, hippocampus, and cerebellum; more limited activations in the light state (bilateral superior temporal gyrus, right thalamus, bilateral parietal cortex, left frontal cortex, and right occipital cortex); and no significant auditory-related activation in the deep state. During recognition testing, subjects correctly selected 77 +/- 12% of words presented while they were awake as "old," versus 32 +/- 15 and 42 +/- 8% (P &lt; 0.01) correct for the light and deep stages, respectively. Conclusions Sevoflurane induces dose-dependent suppression of auditory blood oxygenation level-dependent signals, which likely limits the ability of words to be processed during anesthesia and compromises memory.

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