Mike Notohamiprodjo, Presenter: Nothing to Disclose

Katharina Stella Winter, Abstract Co-Author: Nothing to Disclose

Andreas Dietrich Helck MD, Abstract Co-Author: Nothing to Disclose

Konstantin Nikolaou MD, Abstract Co-Author: Speakers Bureau, Siemens AG Speakers Bureau, Bracco Group Speakers Bureau, Bayer AG

Jozefina Casuscelli, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Christian Stief MD, Abstract Co-Author: Nothing to Disclose

Michael Staehler MD, Abstract Co-Author: Nothing to Disclose

To investigate effects of partial nephrectomy with combined MR-Renography (MRR) and Diffusion-Weighted Imaging (DWI).

This IRB approved prospective study was performed according to the declaration Helsinki. 28 patients with renal tumors underwent MR at 3T directly before and one week after partial nephrectomy. 21 patients were examined 3 months after surgery. MRR and volumetry were performed with a TWIST-sequence (2.5seconds temporal resolution, 5 minutes total acquisition) and analyzed with a 2-compartment-model providing plasma flow/ volume and the glomerular filtration rate (GFR) per 100ml. DWI was acquired with an EPI-sequence (10 b-values 0-800 s/mm2) and monoexponential analysis. Statistical analysis was performed with paired t-tests and Pearson´s correlation coefficient.  

Clamping time (cold ischemia) ranged from 4 to 29 minutes. One week after partial nephrectomy a significant reduction of kidney volume, plasma flow and GFR of the operated kidney by 25±12%, 34±16%, 40±32% (p<0.05) was detected. The contralateral kidney showed no significant difference compared to baseline. ADC showed a reduction of 8±6% in the operated and an increase of 7±8% in the contralateral kidney. Estimated GFR (eGFR) using MDRD showed a significant reduction of 27%. There was a moderate correlation of reduction of plasma flow and GFR to clamping time (r=0.41 and r=0.48). After 3 months plasma flow and GFR were reduced by 11±21% and 10±23%. The contralateral kidney showed an increase of 7±14% and 5±17%. ADC showed a decrease of 5.7±9.2% on the operated side and an increase of 4±7% on the contralateral side. eGFR was not significantly altered (+2%±13%) compared to baseline. 3 patients did not show complete recovery of kidney function (-20±13%).  

MRR detects significant changes in the operated kidney after partial nephrectomy, whereas ADC shows only mild changes. After 3 months, recovery of the operated kidney and contralateral compensation can be demonstrated.

MRR detects significant changes in the operated kidney after partial nephrectomy, whereas ADC shows only mild changes. After 3 months, recovery of the operated kidney and contralateral compensation can be demonstrated.

Notohamiprodjo, M, Winter, K, Helck, A, Nikolaou, K, Casuscelli, J, Reiser, M, Stief, C, Staehler, M, Assessment of Functional Changes after Partial Nephrectomy with Combined MR-Renography and Diffusion-Weighted Imaging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012691.html