The Potentials of Contrast-Free Renal ASL MRI Perfusion in the Diagnosis and Dynamic Follow-Up of Renal Lesions in Patients with Diffuse Liver Diseases

Objective: to evaluate the potentials of contrast-free renal arterial spin labeling (ASL) perfusion during magnetic resonance imaging (MRI) for the diagnosis and dynamic follow-up of renal lesions in patients with diffuse liver diseases (DLD). Material and methods. The prospective study enrolled 82 patients with various DLD: alcoholic, viral, druginduced, autoimmune and mixed etiology. Ultrasound examination with Doppler abdominal and renal ultrasonography was conducted using Apogee 5300 (SIUI, China); abdominal MRI with contrast-free renal ASL-perfusion was performed using Vantage Titan 1.5 T (Toshiba, Japan). The parameters of renal perfusion (renal blood flow, RBF) were measured when the patients were admitted to the hospital, then during dynamic follow-up for 18 months. Results. Mathematical processing of results revealed normal RBF values (≥ 450 ml/100 g/min) and values associated with hepatorenal syndrome (HRS) (≤ 449 ml/100 g/min). High correlation between renal ASL-perfusion indicators and results of Doppler renal vessels ultrasonography was detected (r = 0,856). The diagnostic effectiveness parameters of contrast-free renal ASL-perfusion were: sensitivity 0.83, specificity 0.92, diagnostic accuracy 0.87. We created the algorithm of DLD patients examination for early HRS diagnosis and follow-up. Conclusion. Contrast-free renal ASL-perfusion is an informative method for predicting, diagnosis and dynamic follow-up of renal lesions in patients with various DLD.