TY - JOUR
T1 - Magnetic resonance elastography can monitor changes in medullary stiffness in response to treatment in the swine ischemic kidney
AU - Zhang, Xin
AU - Zhu, Xiangyang
AU - Ferguson, Christopher Martyn
AU - Jiang, Kai
AU - Burningham, Tyson
AU - Lerman, Amir
AU - Lerman, Lilach Orly
N1 - Funding Information:
Acknowledgements This study was partly supported by NIH grants numbers HL123160, DK73608, DK104273, HL121561, C06-RR018898. We are grateful to Medispec® LTD, Gaithersburg, MD, for generously allowing the use of the SW machine. The machine sponsor was not involved in data collection or analysis.
Publisher Copyright:
© 2017, ESMRMB.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - 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.
AB - 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.
KW - Extracorporeal shockwave
KW - Magnetic resonance elastography
KW - Renal artery stenosis
KW - Renal medulla
KW - Stiffness
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U2 - 10.1007/s10334-017-0671-7
DO - 10.1007/s10334-017-0671-7
M3 - Article
C2 - 29289980
AN - SCOPUS:85039696760
SN - 0968-5243
VL - 31
SP - 375
EP - 382
JO - Magnetic Resonance Materials in Physics, Biology, and Medicine
JF - Magnetic Resonance Materials in Physics, Biology, and Medicine
IS - 3
ER -