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• Clinical Article •
Application value of pCASL technique in assessing renal function impairment and staging in chronic kidney disease patients with hypertension
LUO Peiyin  CHEN Qiuyi  LI Junfeng  LIU Wenxi  QI Ruirui  LIANG Qiumei  MENG Fanqi  WANG Wenjing  ZENG Youjia  CHEN Yueyao 

Cite this article as: LUO P Y, CHEN Q Y, LI J F, et al. Application value of pCASL technique in assessing renal function impairment and staging in chronic kidney disease patients with hypertension[J]. Chin J Magn Reson Imaging, 2025, 16(2): 65-71. DOI:10.12015/issn.1674-8034.2025.02.010.


[Abstract] Objective To investigate the value of applying pseudo continuous arterial spin labeling (pCASL) on renal impairment and staging in chronic kidney disease (CKD) patients with or without hypertension.Materials and Methods Twenty healthy volunteers (HV), 34 non- hypertension CKD patients (CN), and 36 hypertension CKD patients (CH) were prospectively analyzed. The CKD patients were further categorized into stage 1-2 and stage 3-5 patients based on estimated glomerular filtration rate (eGFR). Subjects completed pCASL scans, and cortical and medullary renal blood flow (cRBF and mRBF) were measured. Differences in right and left side renal renal blood flow (RBF) values, cRBF and mRBF values were compared separately using paired t-tests. Adjusting for age and body mass index (BMI) as covariates, differences in RBF values between subgroups were compared using covariance (ANCOVA) test. The diagnostic value of renal RBF values for renal injury was analyzed using the receiver operating characteristic (ROC) curve. Spearman's correlation analysis was used to assess the correlation between renal function indexes and RBF values in CKD patients.Results There was no statistically significant difference between the RBF values of the left and right side kidneys (P > 0.05), and the cRBF values of the kidneys in all three groups was greater than the mRBF values (P < 0.05). The overall difference in the RBF values of the HV group, the CN 1-2 stage group, and the CN 3-5 stage group was statistically significant (cRBF: F = 18.423, P < 0.001; mRBF: F = 12.026, P < 0.001), and further two-by-two intergroup comparisons using Bonferroni method showed that except the mRBF values of HV group and CN 1-2 were not statistically significant (P > 0.05), the differences among other subgroups were statistically significant (P < 0.05); the overall difference in RBF values between the HV, CH 1-2 and CH 3-5 stage group was also statistically significant (cRBF: F = 12.452, P < 0.001; mRBF: F = 16.153, P < 0.001). The RBF values of the HV group and the CH 1-2 stage group were also higher than those of the CH 3-5 stage group. The differences in RBF values between the HV group and CH 1-2 group were not statistically significant (P > 0.05). cRBF and mRBF differentiated between HV and CN with AUCs of 0.794 and 0.715, sensitivities of 52.90% and 41.20%, and specificities of 95.00% and 100.00%; whereas differentiated between HV and CH with AUCs of 0.740 and 0.726, sensitivities of 58.30% and 47.20%, and specificities of 85.00% and 100.00%. Correlation analysis showed that all RBF values were positively correlated with eGFR and negatively correlated with serum creatinine and CKD stage.Conclusions pCASL can be used to diagnose CKD and provide a new imaging reference index for the staging of the disease, in which the perfusion indexes in patients with combined hypertension have a better correlation with the renal function indexes, suggesting that the factor of the presence or absence of hypertension should be considered when applying pCASL to quantify the renal perfusion values.
[Keywords] chronic kidney disease；hypertension；pseudo continuous arterial spin labeling；renal blood flow；magnetic resonance imaging

LUO Peiyin1   CHEN Qiuyi1   LI Junfeng1   LIU Wenxi2   QI Ruirui1   LIANG Qiumei1   MENG Fanqi1   WANG Wenjing3   ZENG Youjia3   CHEN Yueyao1*  

1 Department of Radiology, The fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen 518033, China

2 Medical AI Lab, College of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen 518033, China

3 Department of Nephrology, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen 518033, China

Corresponding author: CHEN Y Y, E-mail: drchenyueyao@163.com

Conflicts of interest   None.

Received  2024-11-07
Accepted  2025-01-10
DOI: 10.12015/issn.1674-8034.2025.02.010
Cite this article as: LUO P Y, CHEN Q Y, LI J F, et al. Application value of pCASL technique in assessing renal function impairment and staging in chronic kidney disease patients with hypertension[J]. Chin J Magn Reson Imaging, 2025, 16(2): 65-71. DOI:10.12015/issn.1674-8034.2025.02.010.

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