Temporally Resolved Electrocardiogram-Triggered Diffusion-Weighted Imaging of the Human Kidney: Correlation Between Intravoxel Incoherent Motion Parameters and Renal Blood Flow at Different Time Points of the Cardiac Cycle

PURPOSE:To evaluate the influence of pulsatile blood flow on apparent diffusion coefficients (ADC) and the fraction of pseudodiffusion (FP) in the human kidney. MATERIALS AND METHODS:The kidneys of 6 healthy volunteers were examined by a 3-T magnetic resonance scanner. Electrocardiogram (ECG)-gated and respiratory-triggered diffusion-weighted imaging (DWI) and phase-contrast flow measurements were performed. Flow imaging of renal arteries was carried out to quantify the dependence of renal blood flow on the cardiac cycle. ECG-triggered DWI was acquired in the coronal plane with 16 b values in the range of 0 s/mm and 750 s/mm at the time of minimum (MIN) (20 milliseconds after R wave) and maximum renal blood flow (MAX) (197 ± 24 milliseconds after R wave). The diffusion coefficients were calculated using the monoexponential approach as well as the biexponential intravoxel incoherent motion model and correlated to phase-contrast flow measurements. RESULTS:Flow imaging showed pulsatile renal blood flow depending on the cardiac cycle. The mean flow velocity at MIN was 45 cm/s as compared with 61 cm/s at MAX. Fp at MIN (0.29) was significantly lower than at MAX (0.40) (P = 0.001). Similarly, ADCmono, derived from the monoexponential model, also showed a significant difference (P < 0.001) between MIN (ADCmono = 2.14 ± 0.08 × 10 mm/s) and MAX (ADCmono = 2.37 ± 0.04 × 10 mm/s). The correlation between renal blood flow and Fp (r = 0.85) as well as ADCmono (r = 0.67) was statistically significant. CONCLUSION:Temporally resolved ECG-gated DWI enables for the determination of the diffusion coefficients at different time points of the cardiac cycle. ADCmono and FP vary significantly among acquisitions at minimum (diastole) and maximum (systole) renal blood flow. Temporally resolved ECG-gated DWI might therefore serve as a novel technique for the assessment of pulsatility in the human kidney.