Hypertension Clinical Trial
Official title:
Randomized, Clinical Study to Compare Accuracy of 1.5 T Versus 3 T Magnetic Resonance Arterial Spin Labeling to Measure Renal Blood Flow and the Changes of Renal Perfusion Caused by Physiological Stress (Cold Pressor Test).
In this study we want to compare the accuracy of two methods to measure renal perfusion by
MRI spin labelling technique: the first measurement done with the 1.5 T MRI versus the second
one obtained with the 3.0 T MRI (Siemens MRI device).
Additionally we want to compare the changes of renal perfusion caused by physiological
stress. The used stress test is the cold pressor test done at the forehead.
Magnetic resonance imaging based arterial spin labeling is a technique to measure renal blood
flow. Renal perfusion measurement is an important tool to analyze renal function and to
detect acute kidney injury. The perfusion measurement is based on two data acquisitions, one
with a global inversion prepulse followed by one with a slice selective prepulse (FAIR). The
prepulses lead to a labeling of blood water spins. In contrast to the global inversion
prepulse, the slice selective inversion prepulse only labels the blood water spins inside the
kidney but not the inflowing blood water spins. Subtraction of both images therefore reflects
the local perfusion. A third image without the FAIR preparation pulse is measured to
normalize the signal intensifiers on each patients.
MRI based arterial spin labeling is a noninvasive assessment not using contrast agents to
measure the functional parameters of the kidney. This is avoiding serious complications such
as acute kidney failure and nephrogenic systemic fibrosis. There is no known negative impact
to the patient. In addition we now want to analyze the validity of this MRI‐technique by
provoking acutely changes of renal plasma flow. As a further provocative maneuver we selected
the cold pressor test as a physiological stress test. Forehead cooling activates the
sympathetic nervous system and increases blood pressure and heart rate by causing pain. This
mechanism has got an impact on renal haemodynamics. To minimize the possible cold injuries we
use the 1°C ice water pack only for 60 seconds and avoid the contact to the eyes.
In this study we want to compare the accuracy of two methods to measure renal perfusion by
MRI spin labelling technique: the first measurement done with the 1.5 T MRI versus the second
one obtained with the 3.0 T MRI (Siemens MRI device).
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