Daytime Variation in Kidney Perfusion, Oxygenation, and Sodium Concentration Assessed by Multiparametric MRI in Healthy Volunteers

Background: MRI can provide information on kidney structure, perfusion, and oxygenation. Furthermore, it allows for the assessment of kidney sodium concentrations and handling, allowing multiparametric evaluation of kidney physiology. Multiparametric MRI is promising for establishing prognosis and monitoring treatment responses in kidney diseases, but its intraindividual variation during the day is unresolved.

Purpose: To investigate the variation in multiparametric MRI measurements from the morning to the evening.

Study type: Prospective.

Population: Ten healthy volunteers, aged 29 ± 5 without history of kidney disease.

Field strength/sequence: 3 T/T₁ mapping, blood-oxygen level dependent imaging, arterial spin labeling perfusion imaging, diffusion weighted imaging, and sodium imaging.

Assessment: A multiparametric MRI protocol, yielding T1, R2*, ADC, renal blood flow and renal sodium levels, was acquired in the morning, noon, and evening. The participants were fasting prior to the first examination. Urine biochemical analyses were performed to complement MRI data. The cortex and medulla were analyzed separately in a semi-automatic fashion, and gradients of total sodium concentration (TSC) and R₂* gradients were calculated from outer cortex to inner medulla.

Statistical test: Analyses of variance and mixed-effects models to estimate differences from time of day. Coefficients of variation to assess variability within and between participants. A P-value <0.05 was considered statistically significant.

Results: The coefficients of variation varied from 5% to 18% for proton-based parametric sequences, while it was 38% for TSC over a day.

Data conclusion: Multiparametric MRI is stable over the day. The coefficients of variation over a day were lower for proton multiparametric MRI, but higher for sodium MRI.

Evidence level: 2 TECHNICAL EFFICACY: Stage 2.