Robust, Contrast-Free Functional Renal MRI

慢性肾脏病(CKD)是一个全球性问题，影响着全球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指标，但现有的评估方法 技术是不完美的。黄金标准、准确、基于集合的GFR技术非常耗时， 复杂且很少使用，而廉价、有效的GFR测试，如血清肌酐，往往不准确。作为一名 结果慢性肾脏病，特别是亚临床慢性肾脏病(1期和2期，GFR 60-100ml/min)被严重漏诊， 远远没有得到充分的研究。 对CKD的准确识别在美国黑人中尤为重要。尽管最近在以下方面有所改善 结果，慢性肾脏病在美国黑人中的发病率仍然高出15%，终末期肾病的发病率高出3倍 与非黑人美国人相比。医疗政策、遗传、经济和社会因素都是 被认为是观察到的肾脏结果不平等的偶然原因。不幸的是，在更好的筛查之前 早期肾脏疾病的诊断工具已经可用，CKD的确切决定因素将很难确定。 为此，我们假设，克服与运动敏感度和 生理性MR建模将使肾功能磁共振成像(RfMRI)能够生成 与现有的GFR技术相比，具有更高的安全性、易用性和准确性的生物标记物 提议的目标将开发、验证和测试两种测定美国黑人GFR的新方法 有亚临床肾病的倾向。 目的1：建立并验证稳健血氧仪和脱氧血红蛋白动态敏感对比(DDSC)磁共振成像技术。 目的2：建立并验证运动健壮、血水、螺旋体肾动脉自旋标记磁共振成像。 目的3：评价非裔美国人亚临床肾脏疾病患者的非对比rfMRI。 该提案将包括关键的发展和评估步骤，这些步骤将有助于确定和促进 肾脏非电离、非对比剂流体/血流动力学生物标志物的迅速和广泛采用 为历来服务不足的人群和所有肾病患者提供服务。

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.