Justification of Performing Magnetic Resonance Imaging of the Kidneys in Patients in Critical Conditions

Acute kidney injury is a serious problem in intensive care and healthcare in general. The aim of the study is to determine the opportunities and justify the expediency of performing diffusion–weighted images and ASL-perfusion in assessing morphofunctional renal disorders in patients in critical conditions. Material and methods. 101 patients diagnosed with acute kidney injury on the basis of the RSFHF «City Clinical Hospital № 1» (the town of Smolensk) had magnetic resonance imaging of the kidneys and retroperitoneal organs performed using diffusion-weighted images and ASL-perfusion. The data obtained from the autopsy kidney material of deceased patients (n = 32) were compared with the lifetime indicators of diffusion-weighted images and ASL-perfusion. The control group consisted of 54 volunteers without pathology of the genitourinary system. Results. According to the results of magnetic resonance imaging, all patients were divided into three groups. Group 1 (n = 48) included patients with the following results: there was no qualitative restriction of diffusion, the measured diffusion coefficient was = 1.89–2.1´10– 3 mm2/s, ASL-perfusion was ≤ 469 ml/100g/min. In the 2nd group (n = 31), the following results were obtained: qualitatively – there was no restriction of diffusion, the measured diffusion coefficient was = 1.89–2.1´10-3 mm2/s, ASL-perfusion was ≥ 470 ml/100g/min. In the 3rd group (n = 22), the presence of diffusion restriction was noted, the measured diffusion coefficient was < 1.79´10-3 mm2/s. ASL-perfusion was not required in this group of patients, the results were false positive. Conclusions. Magnetic resonance imaging of the kidneys using diffusion-weighted images and ASL-perfusion makes it possible to determine morphofunctional renal disorders without the use of invasive techniques, as well as to predict the outcome in each group of patients.