Imaging the kidney using magnetic resonance techniques: structure to function

Purpose of review Magnetic resonance imaging (MRI) offers the possibility to non-invasively assess both the structure and function of the kidney in a single MR scan session. This review summarises recent advancements in functional renal MRI techniques, with a particular focus on their clinical relevance. Recent findings A number of MRI techniques have been developed that provide non-invasive measures of relevance to the pathophysiology of kidney disease. Diffusion-weighted imaging (DWI) has been used in chronic kidney disease (CKD) and renal transplantation, and appears promising as a measure of renal impairment and fibrosis. Longitudinal relaxation time (T1) mapping has been utilised in cardiac MRI to measure fibrosis and oedema; recent work suggests its potential for assessment of the kidney. Blood oxygen level dependent (BOLD) MRI to measure renal oxygenation has been extensively studied, but a number of other factors affect results making it hard to draw definite conclusions as to its utility as an independent measure. Phase contrast and arterial spin labelling (ASL) can measure renal artery blood flow and renal perfusion respectively without exogenous contrast, in contrast to dynamic contrast enhanced (DCE) studies. Current data on clinical use of such functional renal MR measures is largely restricted to cross-sectional studies. Summary Renal MRI has seen significant recent interest and advances. Current evidence demonstrates its potential, and next steps include wider evaluation of its clinical application

Clinical and morphological findings on mustard gas [bis (2-chloroethyl) sulfide] poisoning

n 1984 and 1985, a total of eleven Iranian patients were transferred to hospitals in Munich, Germany, after a reported gas attack in the Iran-Iraq war. The initial symptoms and pretreatment in Teheran, Iran, as well as the admittance examination data, the clinical courses of the patients, and the clinical laboratory data in Germany, are reported. The main injuries were to the skin, the eyes, and the respiratory tract. One patient stopped breathing suddenly on the third day of treatment (eight days after the exposure). A large piece of mucous membrane blocking a bronchus was removed during an immediate bronchoscopy, but attempts at resuscitation failed. The most important autopsy findings in this case were severe pseudomembranous inflammation of the trachea and the bronchial tubes. The histological findings are reported. Chemical proof of the poison (mustard gas) was established. A review of the history of chemical warfare, the physical and chemical properties of mustard gas, and a literature survey of clinical findings (including, especially, experiences from World Wars I and II) contribute to the understanding of the actual cases

Lung tumour growth kinetics in SPC-c-Raf-1-BB transgenic mice assessed by longitudinal in-vivo micro-CT quantification

<p>Abstract</p> <p>Background</p> <p>SPC-c-Raf-1-BxB transgenic mice develop genetically induced disseminated lung adenocarcinoma allowing examination of carcinogenesis and evaluation of novel treatment strategies. We report on assessment of lung tumour growth kinetics using a semiautomated region growing segmentation algorithm.</p> <p>Methods</p> <p>156 non contrast-enhanced respiratory gated micro-CT of the lungs were obtained in 12 SPC-raf transgenic (n = 9) and normal (n = 3) mice at different time points. Region-growing segmentation of the aerated lung areas was obtained as an inverse surrogate for tumour burden. Time course of segmentation volumes was assessed to demonstrate the potential of the method for follow-up studies.</p> <p>Results</p> <p>Micro-CT allowed assessment of tumour growth kinetics and semiautomated region growing enabled quantitative analysis. Significant changes of the segmented lung volumes over time could be shown (<it>p </it>= 0.009). Significant group differences could be detected between transgenic and normal animals for time points 8 to 13 months (<it>p </it>= 0.043), when marked tumour progression occurred.</p> <p>Conclusion</p> <p>The presented region-growing segmentation algorithm allows in-vivo quantification of multifocal lung adenocarcinoma in SPC-raf transgenic mice. This enables the assessment of tumour load and progress for the study of carcinogenesis and the evaluation of novel treatment strategies.</p