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Assessment of the Renal Corticomedullary 23Na Gradient Using Isotropic Data Sets

机译：使用各向同性数据集评估肾皮髓髓质化23NA梯度

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Rationale and Objectives: 23Na magnetic resonance imaging is a promising technique for the noninvasive imaging of renal function. Past investigations of the renal corticomedullary [23Na] gradient have relied on imaging only in the coronal plane and on cumbersome calculations of [23Na], which require the use of external phantoms. The aim of this study is therefore two-fold: to use an isotropic three-dimensional data set to compare coronal measurements of renal [23Na] relative to measurements obtained in planes along the corticomedullary gradients and to investigate cerebrospinal fluid (CSF) 23Na signal as an internal reference standard, obviating the need for time-intensive [23Na] calculations. Materials and Methods: Nominal isotropic three-dimensional 23Na MRI data sets were obtained in 14 healthy volunteers before and after a water load. Images were reconstructed in the coronal plane and in planes angled along the direction of the corticomedullary sodium gradients. [23Na] values and values of the corticomedullary [23Na] gradient were measured by placement of a linear region of interest along corticomedullary gradients in both the coronal/nonangled [23Nanon-ang] and the angled [23Naang] image reconstructions. CSF [23Na] was also acquired at multiple levels. Ratios of renal 23Na and CSF 23Na signal were calculated to construct a semiquantitative parameter, [23NaCSF]. Results of water stimulation as measured by [23NaCSF] and [23Naang] were then compared. Results: Mean values of [23Naang] were statistically significantly greater than those of [23Nanon-ang] (P .0001), although these values were linearly correlated (R = 0.553, P .0001) and exhibited similar extents of decreases in absolute terms (P =.2) and in terms of the corticomedullary gradient following the water load. CSF [23Na] did not statistically significantly differ at any level after the water load (P .5) but tended to increase in the cranial direction (P .001). [23NaCSF] measures demonstrated analogous statistical properties to [23Naang] before and after the water load. Conclusions: Assessment of renal corticomedullary [23Na] gradients using isotropic data sets with image reconstructions along the gradients is likely more accurate than measurements in the coronal plane. Because CSF [23Na] differs based on anatomic levels, such measures are useful as an internal reference only if region of interest placement is consistent. With this caveat in mind, normalization of renal to CSF 23Na signal provides a feasible, less cumbersome alternative to [23Na] calculations in intraindividual studies.
机译：理由和目标：23Na磁共振成像对肾功能的无创成像有前途的技术。肾髓质的过去的调查[23Na]梯度一直依赖于仅在冠状平面和[23Na]的繁琐的计算，其需要使用外部幻影成像。因此，本研究的目的是双重的：使用各向同性的三维数据集进行比较肾[23Na]相对于在平面沿皮髓质梯度和调查脑脊液（CSF）获得的测量结果23Na信号作为冠状测量内部参考标准，避免了对时间密集[23Na]的计算的需要。材料和方法：前和水负荷后在14名健康志愿者获得了标称各向同性三维23Na MRI数据集。图像在冠状平面和沿皮髓质钠梯度的方向成角度的平面被重建。 [23Na]通过沿在两个皮髓质梯度感兴趣的线性区域的放置测量的皮髓质[23Na]梯度的值和值冠状/ nonangled [23Nanon昂]和角度[23Naang]图像重建。 CSF [23Na]还取得在多个级别。肾23Na和CSF 23Na信号的比率进行计算，以构造一个半定量参数，[23NaCSF]。如由[23NaCSF]和[23Naang]测定水刺激的结果然后进行比较。结果：[23Naang]的平均值在统计学上比[23Nanon昂]（P＆.0001）的显著更大，虽然这些值线性相关（R = 0.553，P＆.0001），并显示类似的程度在绝对意义（P = 0.2）和水负荷后的皮髓质梯度方面减小。 CSF [23Na]没有统计学显著在水负荷后的任何水平差异（P＆GT; 0.5），但往往在颅方向（P＆LT; 0.001）增加。 [23NaCSF]措施证明类似的统计特性为[23Naang]之前和水负荷后。结论：肾髓质的评估[23Na]使用各向同性数据集沿梯度图像重建梯度可能比在冠状平面中的测量更精确。因为基于解剖水平CSF [23Na]是不同的，这样的措施如仅当感兴趣的放置区域是一致的内部参考是有用的。与此警告一点，肾正常化至CSF 23Na信号提供了一个可行的，不太笨重的替代在个体内研究[23Na]计算。

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