Functional evaluation of renal artery stenosis using MRI

描述(逐字摘自申请人摘要)：肾血管疾病是一种 高血压和肾脏缺血的重要原因。在6000万患有高血压的美国人中，有1%-5%的人患有肾脏血管病因学。此外, 据估计，所有严重肾功能衰竭患者中有15%患有肾脏 动脉狭窄(RAS)和缺血性肾病。这样做的长期目标是 该项目是为了改善血管疾病患者的预后 肾脏方面，如肾血管性高血压和缺血性肾病。 虽然有几种评估解剖或功能的技术 肾动脉疾病的意义是可用的，没有单一的方法可以 提供关于解剖和功能的明确信息 RAS的同时意义。磁共振成像(MRI)评价 与现有技术相比，RAS具有几个潜在的优势。这个 本项目提出的方法提供了一种快速和微创的 用于评估当前每个肾脏的肾功能的技术 在任何其他技术中都无法实现。我们建议继续开发一种 重要指标--肾小球滤过率的MRI测定方法 在一系列体外和体内实验中，对肾功能的影响。 首先，我们建议开发和验证一种新的确定肾脏的方法。 提取分数(EF)使用快速反转-恢复磁共振技术。 其次，我们将开发和验证一种测量肾脏血流量的方法。 (RBF)在体内，能够比 现有的技术。最后，我们将测量RBF、EF和Single的变化 血管紧张素转换后肾小球滤过率 酶(ACE)抑制在猪肾血管性高血压和高血压模型中的作用 缺血性肾病。如果成功，这项研究中开发的方法将 使人们对RAS的生理效应有了新的理解，并将有助于 指导人体实验。

DESCRIPTION (Verbatim from Applicant's Abstract): Renal vascular disease is an important cause of hypertension and renal ischemia. Of the 60 million Americans with hypertension, 1 - 5 percent have a renal vascular etiology. In addition, an estimated 15 percent of all patients with severe renal failure have renal artery stenosis (RAS) and ischemic nephropathy. The long-term objective of this project is to improve the prognosis of patients with vascular diseases of the kidney, such as renovascular hypertension and ischemic nephropathy. While several techniques that evaluate either the anatomy or functional significance of renal artery disease are available, no single method is capable of providing unambiguous information regarding both the anatomic and functional significance of RAS simultaneously. Magnetic resonance imaging (MRI) evaluation of RAS has several potential advantages relative to existing techniques. The method proposed in this project provides a rapid and minimally invasive technique for evaluating the renal function in each kidney that is currently not available from any other techniques. We propose to continue developing an MRI method for determining glomerular filtration rate, an important measurement of renal function, in a series of in vitro and in vivo experiments. First, we propose to develop and validate a novel method for determining renal extraction fraction (EF) using a fast inversion-recovery MRI technique. Secondly, we will develop and validate a method for measuring renal blood flow (RBF) in vivo that is capable of higher spatial and temporal resolution than existing techniques. Finally, we will measure changes in RBF, EF, and single kidney glomerular filtration rate (skGFR) following angiotensin converting enzyme (ACE) inhibition in swine models of renovascular hypertension and ischemic nephropathy. If successful, the method developed in this study will lead to a new understanding of the physiologic effects of RAS, and would help guide experiments in humans.