Functional Imaging of Changes in Human Intrarenal Perfusion Using Quantitative Dynamic Computed Tomography

RATIONALE AND OBJECTIVES: Quantitative dynamic computed tomography was used with perfusion imaging to characterize intrarenal variations in perfusion in normal and abnormal human kidneys. METHODS: Perfusion images were obtained from 14 normal and four abnormal kidneys, comprising a renal tumor, an infarcted renal allograft, and two kidneys in a patient with cyclosporin toxicity. RESULTS: Images demonstrating quantifiable intrarenal variations in perfusion were consistently obtained. Normal cortical and medullary perfusion were 4.7 mL/min/mL and 1.1 mL/min/mL, respectively, consistent with accepted normal ranges. The changes in the abnormal kidneys corresponded with known pathophysiology. CONCLUSION: Computed tomography perfusion imaging creates quantifiable images of renal perfusion with a spatial resolution currently higher than any other functional imaging technique. It offers the opportunity to characterize renal diseases by their relative effects on cortical and medullary perfusion.