The value of magnetic resonance imaging (MRI) in measuring renal perfusion in type-2 diabetic patients

Abstract

Abstract  Objectives: To investigate the correlation between regional glomerular filtration rate (rGFR) and renal blood flow (RBF), to determine whether RBF can be considered a biomarker for diabetic kidney disease (DKD) in patients with type 2 diabetic disease (T2D) and to examine the agreement between arterial spin labelling (ASL) and dynamic contrast-enhancement (DCE) perfusion MRI for RBF measurement.  Methods: Twenty patients with T2D and an estimated glomerular filtration rate (eGFR) of ≥30 mL/min/1.73 m2 were scanned using ASL and DCE (performed on three Tesla MRI scanners and the results analysed using PMI 0.4 software written in IDL 6.4) to independently measure the RBF and estimate the rGFR from the DCE MRI.  Results: For both kidneys, there was no significant correlation between the rGFR and the RBF obtained from DCE and ASL (r = 0.28, p = 0.24 and r = 0.14, p = 0.57, respectively), and no significant difference was found in the RBF between the ASL and DCE (p = 0.22). A Bland–Altman plot showed good agreement between ASL and DCE for measuring RBF.  Conclusion: The lack of correlation between rGFR and RBF in this study may indicate that RBF is less reliable for detecting DKD in T2D patients. However, future studies using a more reliable estimate for GFR are needed to confirm this. The results also demonstrate the potential of ASL to measure RBF in diabetic patients, making it a powerful alternative to DCE for measuring RBF.