MEASUREMENT OF NORMAL RENAL-ARTERY BLOOD-FLOW - CINE PHASE-CONTRAST MR-IMAGING VS CLEARANCE OF P-AMINOHIPPURATE

OBJECTIVE. The purpose of this study was to compare cine phase-contrast MR imaging with renal clearance of p-aminohippurate for measuring normal renal blood flow. A reliable technique for evaluation of renal hemodynamics would be useful for studying renal vascular diseases and the effects of treatment. Measurements of renal blood flow based on renal clearance of p-aminohippurate are limited in that the kidneys are not studied separately, temporal resolution is poor, and normal renal function is required. SUBJECTS AND METHODS. Bilateral oblique sagittal cine phase-contrast MR images were obtained simultaneously in 10 healthy adult volunteers, with the imaging planes oriented perpendicular to the left and right renal arteries in order to measure through-plane flow. Velocity encoding was 150 cm/sec (seven of 10 volunteers) and 100 cm/sec (eight of 10 volunteers). Axial cine phase-contrast images of the abdominal aorta above and below the origins of the renal arteries were obtained in six volunteers. In these cases, renal blood flow was determined by measuring the difference between suprarenal and infrarenal aortic flow. For all volunteers, renal clearance of p-aminohippurate was determined immediately after MR measurements. RESULTS. Renal blood flow measurements determined by using cine phase-contrast MR imaging were in close agreement with those determined by using clearance of p-aminohippurate. At a velocity encoding of 150 cm/sec, the mean difference was 69 ml/min (95% confidence interval, -31 to 169 ml/min). At a velocity encoding of 100 cm/sec, the mean difference was 39 ml/min (95% confidence interval, -100 to 177 ml/min). Aortic flow measurements using cine phase-contrast MR imaging appeared to be less reliable for determining renal blood flow than measurements in the individual renal arteries, with a mean difference of -75 ml/min (95% confidence interval, -381 to 231 ml/min) compared with renal blood flow determined by using clearance of p-aminohippurate. CONCLUSION. We conclude that cine phase-contrast MR imaging is a promising technique for noninvasive measurement of renal blood flow. Measurements agreed closely with those obtained by using clearance of p-aminohippurate. In addition, the MR technique is faster, can be used to measure unilateral or bilateral renal blood flow, and does not depend on renal function.