Dynamic magnetic resonance nephrography: is saturation recovery TrueFISP advantageous over saturation recovery TurboFLASH?

PURPOSE: In this volunteer study, 2 navigator-gated strongly T1-weighted saturation-recovery (SR) sequences, a turbo fast low angle shot (TurboFLASH) and a new true fast imaging in steady precession (TrueFISP) readout technique, were compared for suitability in dynamic magnetic resonance nephrography. MATERIALS AND METHODS: Ten healthy volunteers (mean age 26.1 +/- 3.6) were equally divided into 2 subgroups. After bolus-injection of 3.75 mL of gadobutrol (approximately 0.05 mmol/kg body weight), slightly obliqued coronal single-slice images of the kidneys were recorded every 4-5 seconds during free breathing using 1 of the 2 sequences. Time-intensity curves were determined from manually drawn regions-of-interest over the kidney parenchyma. Both sequences were subsequently evaluated with regard to linearity of signal, signal to noise ratio (SNR), and time-dependent behavior of signal intensity curves. RESULTS: : The TurboFLASH readout showed better linearity of the signal behavior as compared with the TrueFISP technique (TurboFLASH: no deviation from linearity down to T1 = 400 milliseconds; TrueFISP at T1 = 700 milliseconds: 12% deviation, at T1 = 400 milliseconds: 19%). The time-intensity curves of the TrueFISP sequence exhibited distinctly lower variability than the TurboFLASH approach. The SNR increased with TrueFISP by 3.4 +/- 0.5-fold for native renal parenchyma and by 3.3 +/- 0.9 for contrast-enhanced renal parenchyma. For split renal function evaluation, the linear regression to the signal increase in the first minutes after the first pass could be performed with higher reliability using the TrueFISP technique (increase of correlation coefficient by 17.1%). CONCLUSION: A SR navigator-gated TrueFISP sequence seems most favorable for dynamic magnetic resonance nephrography due to the high signal yield and low curve variability.

Quantitative assessment of glomerular filtration rate with MR gadolinium slope clearance measurements: a phase I trial.

PURPOSE: To prospectively demonstrate the feasibility of quantifying the glomerular filtration rate (GFR) by assessing the renal clearance of gadolinium-based contrast medium from the extracellular fluid volume in healthy volunteers. MATERIALS AND METHODS: The study was approved by the ethics committee and the governmental drug administration department (registration number 4030139, EudraCT number 2004-002969-20, study protocol number 318/2004). Informed consent was obtained from 16 healthy volunteers (six female, 10 male; mean age, 24.5 years +/- 2.8 [standard deviation]). Thirteen volunteers (four women, nine men; mean age, 24.8 years +/- 2.7; range, 23-30 years) successfully contributed to the study. The GFR was assessed by recording the renal clearance of gadobutrol (3.75 mL, approximately 0.05 mmol per kilogram of body weight) at navigator-gated turbo fast low-angle shot magnetic resonance (MR) imaging. Time-signal intensity curves were constructed from manually drawn regions of interest in the liver, spleen, and renal cortex, and the GFR was calculated by using exponential fitting. Simultaneously obtained iopromide clearance measurements were the reference standard. Statistical evaluations included Bland-Altman plotting and analysis of the relative deviation from iopromide clearance. RESULTS: Evaluation of liver regions of interest revealed the lowest mean of paired differences from the iopromide clearance measurements (-5.9 mL/min per 1.73 m(2) +/- 14.6), with a mean GFR of 109.0 mL/min per 1.73 m(2) +/- 17.1 (134.1 mL/min per 1.73 m(2) +/- 35.4 for spleen, 100.7 mL/min per 1.73 m(2) +/- 25.1 for renal cortex) compared with a mean GFR of 103.1 mL/min per 1.73 m(2) +/- 9.4 measured by using iopromide clearance. The maximum deviation of MR-determined gadobutrol clearance values from iopromide clearance values was 29.2%. The mean disposition half-life of gadobutrol measured in the liver was 83.0 minutes +/- 14.2 (72.4 minutes +/- 20.2 in spleen, 92.6 minutes +/- 23.7 in renal cortex). CONCLUSION: The described MR imaging method enables absolute quantification of the GFR after routine contrast material-enhanced MR imaging.