Radiologic imaging of the renal parenchyma structure and function

Key Points Radiologic techniques can be used to assess gross renal morphology, but morphological changes at this level show poor correlation with renal function and the changes over time are often nonspecific Dynamic contrast-enhanced CT or MRI can provide haemodynamic information, such as renal blo...

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Veröffentlicht in:Nature reviews. Nephrology Jg. 12; H. 6; S. 348 - 359
Hauptverfasser: Grenier, Nicolas, Merville, Pierre, Combe, Christian
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London Nature Publishing Group UK 01.06.2016
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ISSN:1759-5061, 1759-507X, 1759-507X
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Abstract Key Points Radiologic techniques can be used to assess gross renal morphology, but morphological changes at this level show poor correlation with renal function and the changes over time are often nonspecific Dynamic contrast-enhanced CT or MRI can provide haemodynamic information, such as renal blood flow or tissue perfusion, which can facilitate personalized patient management Information obtained from blood oxygen level-dependent MRI could contribute to the understanding of chronic kidney disease pathophysiology, but technical issues remain to be solved before large-scale clinical use MRI and renal scintigraphy can both provide a measure of split renal function in moderately dilated kidneys, but radiological measurement of single kidney glomerular filtration rate requires further development The ability to identify fibrotic changes and inflammatory components in damaged renal tissue by radiologic imaging is a major goal for future research Radiologic techniques are routinely used to assess tissue macrostructure and gross morphology. In this Review, Nicolas Grenier and colleagues discuss how technological advancements in CT, MRI, and ultrasonography have faciliated the assessment of organ microstructure and function, and how these techniques can be applied to the kidney. They outline the benefits of incorporating radiologic data with routine clinical diagnostics, and the technical challenges that remain to be addressed when imaging the kidney. Radiologic imaging has the potential to identify several functional and/or structural biomarkers of acute and chronic kidney diseases that are useful diagnostics to guide patient management. A renal ultrasound examination can provide information regarding the gross anatomy and macrostructure of the renal parenchyma, and ultrasound imaging modalities based on Doppler or elastography techniques can provide haemodynamic and structural information, respectively. CT is also able to combine morphological and functional information, but the use of CT is limited due to the required exposure to X-ray irradiation and a risk of contrast-induced nephropathy following intravenous injection of a radio-contrast agent. MRI can be used to identify a wide range of anatomical and physiological parameters at the tissue and even cellular level, such as tissue perfusion, oxygenation, water diffusion, cellular phagocytic activity, tissue stiffness, and level of renal filtration. The ability of MRI to provide valuable information for most of these parameters within a renal context is still in development and requires more clinical experience, harmonization of technical procedures, and an evaluation of reliability and validity on a large scale.
AbstractList Radiologic imaging has the potential to identify several functional and/or structural biomarkers of acute and chronic kidney diseases that are useful diagnostics to guide patient management. A renal ultrasound examination can provide information regarding the gross anatomy and macrostructure of the renal parenchyma, and ultrasound imaging modalities based on Doppler or elastography techniques can provide haemodynamic and structural information, respectively. CT is also able to combine morphological and functional information, but the use of CT is limited due to the required exposure to X-ray irradiation and a risk of contrast-induced nephropathy following intravenous injection of a radio-contrast agent. MRI can be used to identify a wide range of anatomical and physiological parameters at the tissue and even cellular level, such as tissue perfusion, oxygenation, water diffusion, cellular phagocytic activity, tissue stiffness, and level of renal filtration. The ability of MRI to provide valuable information for most of these parameters within a renal context is still in development and requires more clinical experience, harmonization of technical procedures, and an evaluation of reliability and validity on a large scale.
Radiologic imaging has the potential to identify several functional and/or structural biomarkers of acute and chronic kidney diseases that are useful diagnostics to guide patient management. A renal ultrasound examination can provide information regarding the gross anatomy and macrostructure of the renal parenchyma, and ultrasound imaging modalities based on Doppler or elastography techniques can provide haemodynamic and structural information, respectively. CT is also able to combine morphological and functional information, but the use of CT is limited due to the required exposure to X-ray irradiation and a risk of contrast-induced nephropathy following intravenous injection of a radio-contrast agent. MRI can be used to identify a wide range of anatomical and physiological parameters at the tissue and even cellular level, such as tissue perfusion, oxygenation, water diffusion, cellular phagocytic activity, tissue stiffness, and level of renal filtration. The ability of MRI to provide valuable information for most of these parameters within a renal context is still in development and requires more clinical experience, harmonization of technical procedures, and an evaluation of reliability and validity on a large scale.Radiologic imaging has the potential to identify several functional and/or structural biomarkers of acute and chronic kidney diseases that are useful diagnostics to guide patient management. A renal ultrasound examination can provide information regarding the gross anatomy and macrostructure of the renal parenchyma, and ultrasound imaging modalities based on Doppler or elastography techniques can provide haemodynamic and structural information, respectively. CT is also able to combine morphological and functional information, but the use of CT is limited due to the required exposure to X-ray irradiation and a risk of contrast-induced nephropathy following intravenous injection of a radio-contrast agent. MRI can be used to identify a wide range of anatomical and physiological parameters at the tissue and even cellular level, such as tissue perfusion, oxygenation, water diffusion, cellular phagocytic activity, tissue stiffness, and level of renal filtration. The ability of MRI to provide valuable information for most of these parameters within a renal context is still in development and requires more clinical experience, harmonization of technical procedures, and an evaluation of reliability and validity on a large scale.
Key Points Radiologic techniques can be used to assess gross renal morphology, but morphological changes at this level show poor correlation with renal function and the changes over time are often nonspecific Dynamic contrast-enhanced CT or MRI can provide haemodynamic information, such as renal blood flow or tissue perfusion, which can facilitate personalized patient management Information obtained from blood oxygen level-dependent MRI could contribute to the understanding of chronic kidney disease pathophysiology, but technical issues remain to be solved before large-scale clinical use MRI and renal scintigraphy can both provide a measure of split renal function in moderately dilated kidneys, but radiological measurement of single kidney glomerular filtration rate requires further development The ability to identify fibrotic changes and inflammatory components in damaged renal tissue by radiologic imaging is a major goal for future research Radiologic techniques are routinely used to assess tissue macrostructure and gross morphology. In this Review, Nicolas Grenier and colleagues discuss how technological advancements in CT, MRI, and ultrasonography have faciliated the assessment of organ microstructure and function, and how these techniques can be applied to the kidney. They outline the benefits of incorporating radiologic data with routine clinical diagnostics, and the technical challenges that remain to be addressed when imaging the kidney. Radiologic imaging has the potential to identify several functional and/or structural biomarkers of acute and chronic kidney diseases that are useful diagnostics to guide patient management. A renal ultrasound examination can provide information regarding the gross anatomy and macrostructure of the renal parenchyma, and ultrasound imaging modalities based on Doppler or elastography techniques can provide haemodynamic and structural information, respectively. CT is also able to combine morphological and functional information, but the use of CT is limited due to the required exposure to X-ray irradiation and a risk of contrast-induced nephropathy following intravenous injection of a radio-contrast agent. MRI can be used to identify a wide range of anatomical and physiological parameters at the tissue and even cellular level, such as tissue perfusion, oxygenation, water diffusion, cellular phagocytic activity, tissue stiffness, and level of renal filtration. The ability of MRI to provide valuable information for most of these parameters within a renal context is still in development and requires more clinical experience, harmonization of technical procedures, and an evaluation of reliability and validity on a large scale.
Audience Academic
Author Grenier, Nicolas
Merville, Pierre
Combe, Christian
Author_xml – sequence: 1
  givenname: Nicolas
  surname: Grenier
  fullname: Grenier, Nicolas
  email: nicolas.grenier@chu-bordeaux.fr
  organization: Service d'Imagerie Diagnostique et Interventionnelle de l'Adulte, Centre Hospitalier Universitaire de Bordeaux, Groupe Hospitalier Pellegrin
– sequence: 2
  givenname: Pierre
  surname: Merville
  fullname: Merville, Pierre
  organization: University of Bordeaux
– sequence: 3
  givenname: Christian
  surname: Combe
  fullname: Combe, Christian
  organization: Service de Néphrologie Transplantation Dialyse, Centre Hospitalier Universitaire de Bordeaux, Groupe Hospitalier Pellegrin
BackLink https://www.ncbi.nlm.nih.gov/pubmed/27067530$$D View this record in MEDLINE/PubMed
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Snippet Key Points Radiologic techniques can be used to assess gross renal morphology, but morphological changes at this level show poor correlation with renal...
Radiologic imaging has the potential to identify several functional and/or structural biomarkers of acute and chronic kidney diseases that are useful...
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SubjectTerms 692/4022/1585
692/700/1421
Animals
Biomarkers
Diagnostic imaging
Hemodynamics
Humans
Kidney - anatomy & histology
Kidney - diagnostic imaging
Kidney - metabolism
Kidney - physiopathology
Kidney diseases
Kidney Diseases - diagnostic imaging
Kidney Diseases - metabolism
Kidney Diseases - pathology
Kidney Diseases - physiopathology
Kidneys
Magnetic fields
Magnetic Resonance Imaging
Medical examination
Medicine & Public Health
Morphology
Nephrology
Oxygen - metabolism
Parenchymal Tissue - diagnostic imaging
review-article
Tomography, X-Ray Computed
Ultrasonic imaging
Ultrasonography
Title Radiologic imaging of the renal parenchyma structure and function
URI https://link.springer.com/article/10.1038/nrneph.2016.44
https://www.ncbi.nlm.nih.gov/pubmed/27067530
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Volume 12
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