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Magnetic resonance imaging as a sole method for the morphological and functional evaluation of live kidney donors
Author(s) -
ElDiasty Tarek A.,
ElGhar Mohamed E. Abo,
Shokeir Ahmed A.,
Gad Hossam M.,
Wafa Ehab W.,
ElAzab Mohamed E.,
ElDin Ahmed B. Shehab,
Ghoneim Mohamed A.
Publication year - 2005
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2005.05578.x
Subject(s) - kidney , medicine , renal function , magnetic resonance imaging , nephrectomy , urology , scintigraphy , nuclear medicine , radiology
In this section, authors from Mansoura describe their experience with MRI as the sole method for the morphological and functional evaluation of live kidney donors. They recommend this technique in both instances. A series of studies from Detroit show that oxalate and hyperoxaluria induced free‐radical generation, which resulted in injury to renal tubular cells. In this paper they show for the first time that hyperoxaluria‐induced injury promotes individual calcium oxalate crystal attachment in the renal tubules. They also showed that this was prevented by vitamin E treatment. OBJECTIVE To evaluate gadolinium‐enhanced dynamic magnetic resonance imaging (MRI) as the sole method for the anatomical and functional assessment of potential live‐kidney donors. SUBJECTS AND METHODS The study included 50 consecutive kidney donors; in addition to routine donor evaluation, the kidney was imaged with Gd‐enhanced dynamic MRI, which was also used for selectively determining the glomerular filtration rate (GFR) of each kidney. All donors had a m99 Tc‐mercaptoacetyltriglycine (MAG3) renal scan as the reference standard to measure GFR. The anatomical results of MRI were compared with the findings at donor nephrectomy, and the GFR estimated from MRI compared with that from MAG3 scintigraphy. RESULTS MR angiography had 100% sensitivity, 94% specificity and 96% overall accuracy for detecting the number of renal arteries, and 100% sensitivity, 98% specificity and 98% overall accuracy for the number of renal veins. There was a close correlation ( r = 0.54, P < 0.01) between the GFR of each kidney estimated by MRI or MAG3. For the right and left kidneys the mean isotope clearance was not significantly different from that of mean MRI clearance. MR urography allowed visualization of the urinary tract and the detection of any abnormality. CONCLUSION Gd‐enhanced dynamic MRI can provide accurate information about the anatomy of the urinary tract and vasculature of the kidney, and can be used to accurately estimate the selective GFR of each kidney. Therefore, we recommend MRI as a single imaging diagnostic method for assessing potential live kidney donors.