Pd12-07 a Virtual Method for Measuring Bladder Blood Flow Relative to Femoral Artery

You have accessJournal of UrologyBladder & Urethra: Anatomy, Physiology & Pharmacology (PD12)1 May 2024PD12-07 A VIRTUAL METHOD FOR MEASURING BLADDER BLOOD FLOW RELATIVE TO FEMORAL ARTERY Pradeep Tyagi, Sholosh Biatta, Chan-Hong Moon, Naoki Yoshimura, Jodi Maranchie, and Christopher Chermansky Pradeep TyagiPradeep Tyagi , Sholosh BiattaSholosh Biatta , Chan-Hong MoonChan-Hong Moon , Naoki YoshimuraNaoki Yoshimura , Jodi MaranchieJodi Maranchie , and Christopher ChermanskyChristopher Chermansky View All Author Informationhttps://doi.org/10.1097/01.JU.0001008772.30001.48.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The essence of normal bladder capacity is high metabolic rate of mucosa relative to detrusor muscle during storage phase, which is dependent on skewed blood flow into unique vascular architecture of mucosa. However, there is dearth of reliable methods for measuring bladder perfusion as the most widely used method of laser Doppler requires direct application of probe to the bladder wall and the readings are prone to errors linked to site-selection bias and variable bladder wall thickness. We theorized that dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) can provide reliable and robust readouts of bladder wall perfusion relative to femoral artery because DCE of any voxel at any frame is predicated on the localized dilution of the injected Gadolinium chelate in accordance with indicator dilution principle (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6588202/). METHODS: This hypothesis generating study of MRI scans in a educational setting met the 45 CFR 46.104(d)(4) exemption criteria for clinical research. We analyzed the T1-weighted signal intensity ratio between radiologically normal bladder wall and femoral artery at 30, 60 and 90 s after i.v. injection of Gadopiclenol 0.05 mmol/kg or gadobenate dimeglumine 0.1 mmol/kg in three deidentifed pelvic DCE -MRI scans. 3D fat-suppressed gradient-echo scans in sagittal plane were acquired at 1.5 T scanner with 8 channel lower body coil using repetition time/echo time of 3.69-4.4/1.7-2.13 ms, flip angle 12, slice thickness 5-8 mm, FOV 300-410 mm and matrix of 256×192. RESULTS: Highly perfused state of bladder wall during storage phase is evinced by the coincidence of peak enhancement of bladder wall and femoral artery. Since the magnitude of the bladder wall peak is only a third of femoral artery, bladder blood flow rate is estimated to be a third of the femoral artery blood flow rate of 350±141 mL/min (PMID: 2948313). Thus, the estimated blood flow rate for normal bladder wall is ∼ 100 mL/min or 2% of the cardiac output (5 L/min) which agrees with one study on laser Doppler method that reported bladder blood flow in mL/min (PMID: 10566538) as opposed to arbitrary units reported by other studies, which made comparison difficult. CONCLUSIONS: Thus, relative contrast enhancement of bladder wall in pelvic DCE-MRI scans is a valuable repository for determining bladder perfusion that precipitates ischemia secondary to inflammation or outlet obstruction. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e258 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Pradeep Tyagi More articles by this author Sholosh Biatta More articles by this author Chan-Hong Moon More articles by this author Naoki Yoshimura More articles by this author Jodi Maranchie More articles by this author Christopher Chermansky More articles by this author Expand All Advertisement PDF downloadLoading ...