Chronic Kidney Disease (CKD) is characterized by a gradual loss of kidney function, and it’s a common disease among adults in the United States. One of the leading causes of death of patients with end-stage CKD is vascular disease. Contrast Enhanced Magnetic Resonance Angiography (CEMRA) enables the visualization of vessels with high resolution but clinically used contrast agents are gadolinium (Gd) based, which carries a risk of severe side effects.
Our lab developed a technique called Quantitative Ultrashort Time-to-Echo Contrast Enhanced (QUTE-CE) MRA, which uses a safer contrast agent (ferumoxytol) and a UTE sequence. QUTE-CE MRA images were successfully acquired in 4 human subjects. These images have higher angiographic imaging quality with high Signal-to-Noise Ratio, Contrast-to-Noise Ratio and intraluminal vessel homogeneity. We performed morphometric analysis of kidney vessels using the Vascular Modeling ToolKit (VMTK) and three quantitative metrics were given. (1) Branching order. QUTE-CE MRA captures deeper kidney vessels compared to Gd CEMRA (7th vs 3rd); (2) Vascular curvature. Mean vascular curvature of a cystic kidney is larger compared to a normal kidney (0.06±0.04 vs 0.05±0.03); (3) Renal artery diameters of 8 kidneys varied between 4.50 to 7.51 mm. A narrowing (28.7%) in one renal artery was observed.
This new MRA technique is a safer alternative to the current standard Gd CEMRA technique for CKD patients. The quantitative metrics of vascular abnormalities have promise for diagnose and characterization of CKD.