Robust, Contrast-Free Functional Renal MRI

慢性肾脏病（CKD）是一个全球性问题，影响全球5亿人。肾小球滤过 肾小球滤过率（GFR）是评估肾功能的临床标准测定，然而现有的估计 技术是不完美的。金标准、准确、基于收集的GFR技术是耗时的， 然而，像血清肌酐这样的便宜、有效的GFR测试通常是不准确的。作为 结果，CKD，特别是亚临床CKD（1期和2期，GFR 60-100 ml/min）严重诊断不足， 被大大低估了 准确识别CKD在美国黑人中尤为重要。尽管最近的改善， 结果，CKD仍然比美国黑人高15%，终末期肾病比美国黑人高3倍 与非黑人美国人相比。医疗政策、遗传学、经济学和社会因素都被 被认为是观察到的肾脏结局不平等的偶然原因。不幸的是，在更好的筛查之前 早期肾脏疾病的工具是可用的，CKD的确切决定因素将难以确定。 为此，我们假设，克服与运动敏感性相关的技术挑战， 生理MR建模将使肾功能磁共振成像（rfMRI）能够生成 与现有GFR技术相比，具有上级安全性、简便性和准确性的生物标志物 提出的目标将开发，验证和测试两种新的方法GFR测定在美国黑人 有亚临床肾病的倾向 目的1：开发和验证稳健的血氧测定和脱氧血红蛋白动态敏感对比（dDSC）MRI。 目的2：开发和验证运动稳健、血液、PROPELLER肾动脉自旋标记MRI。 目的3：评价非裔美国人亚临床肾病成人的非对比rfMRI。 该提案将包括关键的开发和评估步骤，这些步骤将有助于确定和促进 快速和广泛采用非电离、非造影剂的肾脏水/血液动力学生物标志物 为历史上服务不足的人群和所有肾病患者提供功能。

Chronic kidney disease (CKD) is a global problem affecting 500 million people worldwide. Glomerular filtration rate (GFR) is the clinical standard assay for the assessment of kidney function, however existing estimation techniques are imperfect. Gold-standard, accurate, collection based GFR techniques are time consuming, complex and rarely used, whereas cheap, effective GFR test like serum creatinine are often inaccurate. As a result, CKD, particularly subclinical CKD (Stage 1 and 2, GFR 60-100 ml/min) is grossly under-diagnosed and vastly understudied. Accurate identification of CKD is particularly important in Black Americans. Despite recent improvements in outcomes, CKD remains 15% more common, and end stage renal disease 3x more common in Black Americans as compared to non-Black Americans. Medical policy, genetics, economics and social factors have all been suggested as casual reasons for the observed inequities in renal outcomes. Unfortunately, until better screening tools of early renal disease are available, the exact determinants of CKD will be difficult to establish. Toward this end, we hypothesize that overcoming technical challenges related to motion sensitivity and physiological MR modeling will enable renal functional magnetic resonance imaging (rfMRI) to generate biomarkers that have superior safety, ease and accuracy as compared to existing GFR techniques The proposed aims will develop, validate and test two novel methods of GFR determination in Black Americans with a propensity for subclinical kidney disease. Aim 1: Develop and Validate Robust Oximetry and DeoxyHb Dynamic Susceptibly Contrast (dDSC) MRI. Aim 2: Develop and Validate Motion Robust, Blood Water, PROPELLER Renal Arterial Spin Labeling MRI. Aim 3: Evaluate Non-Contrast rfMRI in Adult African Americans with Subclinical Renal Disease. This proposal will consist of critical development and evaluation steps that will help characterize and facilitate the rapid and widespread adoption of non-ionizing, non-contrast hydro/hemodynamic biomarkers of renal function for a historically underserved population and all patients with kidney disease.