Magnetic resonance elastography can monitor changes in medullary stiffness in response to treatment in the swine ischemic kidney

Xin Zhang, Xiangyang Zhu, Christopher Martyn Ferguson, Kai Jiang, Tyson Burningham, Amir Lerman, Lilach O Lerman

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Objective: Low-energy shockwave (SW) therapy attenuates damage in the stenotic kidney (STK) caused by atherosclerotic renal artery stenosis (ARAS). We hypothesized that magnetic resonance elastography (MRE) would detect attenuation of fibrosis following SW in unilateral ARAS kidneys. Materials and methods: Domestic pigs were randomized to control, unilateral ARAS, and ARAS treated with 6 sessions of SW over 3 consecutive weeks (n = 7 each) starting after 3 weeks of ARAS or sham. Four weeks after SW treatment, renal fibrosis was evaluated with MRE in vivo or trichrome staining ex vivo. Blood pressure, single-kidney renal-blood-flow (RBF) and glomerular-filtration-rate (GFR) were assessed. Results: MRE detected increased stiffness in the STK medulla (15.3 ± 2.1 vs. 10.1 ± 0.8 kPa, p < 0.05) that moderately correlated with severity of fibrosis (R2 = 0.501, p < 0.01), but did not identify mild STK cortical or contralateral kidney fibrosis. Trichrome staining showed that medullary fibrosis was increased in ARAS and alleviated by SW (10.4 ± 1.8% vs. 2.9 ± 0.2%, p < 0.01). SW slightly decreased blood pressure and normalized STK RBF and GFR in ARAS. In the contralateral kidney, SW reversed the increase in RBF and GFR. Conclusion: MRE might be a tool for noninvasive monitoring of medullary fibrosis in response to treatment in kidney disease.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalMagnetic Resonance Materials in Physics, Biology and Medicine
DOIs
StateAccepted/In press - Dec 30 2017

Keywords

  • Extracorporeal shockwave
  • Magnetic resonance elastography
  • Renal artery stenosis
  • Renal medulla
  • Stiffness

ASJC Scopus subject areas

  • Biophysics
  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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