Revealing the Decrease of Renal Cortical Perfusion in Primary Glomerular Disease and Renal Aging by Arterial Spin Labeling

 To reveal the change of renal cortical blood perfusion in primary glomerular disease (PGD) and renal aging by flow-sensitive alternating inversion recovery (FAIR) arterial spin labeling (ASL) technique.
Patients and

 Renal cortical perfusion was estimated in 24 PGD patients and 30 healthy volunteers using FAIR-ASL in this case-control study. MRI examination was repeated after one week in six randomly selected healthy volunteers. In PGD patients, we regard estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 as mild PGD and eGFR < 60 mL/min/1.73 m2 as moderate-late PGD. The correlations between ASL perfusion values and eGFR in healthy volunteers, mild and moderate-late PGD patients were assessed.

 In healthy volunteers, the perfusion values between the twice ASL scanning with one week-interval showed an excellent agreement by Bland-Altman analysis. The mean perfusion value of the bilateral kidneys decreased with age increase (25 - 72 years) (r = -0.496, P = 0.012). There were significant differences in ASL perfusion values among healthy volunteers, mild and moderate-late PGD patients (P < 0.0001). Perfusion values correlated strongly with eGFR in all PGD patients (r = 0.868, P < 0.0001), but not in healthy volunteers (r = 0.156, P = 0.405). The correlation coefficient of perfusion values with eGFR in mild and moderate-late PGD patients were 0.749 (P = 0.008) and 0.809 (P = 0.010), respectively.

 FAIR-ASL technique represents a feasible approach to monitor the renal perfusion variations in PGD patients. It is a noninvasive technique to discover the early abnormality of renal function, and assess the degree of renal aging.