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Split renal function estimated from dynamic contrast enhanced and respiratory triggered MRI - comparison with gamma camera renography and computed tomography.
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
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Article in journal (Refereed) Submitted
URN: urn:nbn:se:uu:diva-96845OAI: oai:DiVA.org:uu-96845DiVA: diva2:171559
Available from: 2008-03-14 Created: 2008-03-14Bibliographically approved
In thesis
1. Alternative Methods for Assessment of Split Renal Function
Open this publication in new window or tab >>Alternative Methods for Assessment of Split Renal Function
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Living kidney donation is a clinical situation with unique features in the sense that healthy individuals voluntarily expose themselves to certain risks and inconveniences. Therefore, eliminating as much of the associated discomfort as possible is crucial. The primary aim of this study was to evaluate whether it is possible to use the examination with computed tomography (CT), which is essential to the investigation, also for determining the ratio of the two kidneys’ function – the split renal function. If possible, an examination with gamma camera renography could be excluded from the work-up.

To investigate this possibility, 27 subjects who had underwent CT and renography as part of kidney donor investigation were studied retrospectively. The quantity of contrast material in each kidney was considered proportional to that kidney’s function, and measurement was made in each of the two available contrast phases. The results were compared to the results from renography. A similar analysis was conducted in 38 patients investigated for suspected renal artery stenosis with CT and renography, including a study of an automatized method for the acquisition of data from CT. For further scrutiny, a respiratory triggered dynamic contrast-enhanced magnetic resonance imaging (MRI) examination was investigated in 26 individuals. Results of split renal function were compared with renography and with CT in a subgroup. To study the possibility of facilitating the data analysis with CT, a formula for approximation of the contrast attenuation was studied in 64 subjects. An analysis of the significance of choice of contrast phase was also conducted in 43 subjects.

Unsatisfactory agreement with renography resulted from the CT analysis of previous donors, partly due to technical shortcomings. However, the technique was recognized to have a potential value. In the subsequent material, the settings were improved, with beneficial effects on the agreement. Respiratory-triggered MRI generated high quality examinations of renal uptake and excretion, with results harmonizing well with renography and CT. The approximation formula applied to CT resulted in higher accuracy for renal volume assessment than with the automatic method, and an acceptable agreement of the split renal function estimate.

From the presented results, a revision of the current donor investigation protocol is suggested. CT gives sufficient information to exclude renography as a routine examination. In cases of uncertainty, renography is recommended for secondary evaluation.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 76 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 319
Radiology, Split renal function, Live kidney donor, CT, Renography, Dynamic MRI, Renal volume, Respiratory triggering, Radiologisk forskning
urn:nbn:se:uu:diva-8513 (URN)978-91-554-7121-7 (ISBN)
Public defence
2008-04-04, Rosénsalen, Akademiska sjukhuset, Ing. 95/96 n.b.v., Uppsala, 09:15
Available from: 2008-03-14 Created: 2008-03-14Bibliographically approved

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