Использование антропометрической оценки почек и надпочечников методами МР-томографии для прогнозирования эффективности ренальной симпатической денервации почечных артерий у пациентов с медикаментозно резистентной артериальной гипертонией

Aim : to evaluate the possible role of contrast-enhanced MRI studies of the kidneys in prognosis of clinical effect of the renal denervation treatment of the resistant hypertension. Material and methods . 24 patients (57.8 ± 8.75 years) with resistant hypertension were included, in everybody the radiofrequency ablation (RFA) of the sympathetic nerves of renal arteries was carried out. The average 24-h monitor of the arterial pressure was as 137–210/57–148 mm Hg. The MRI studies were performed using MRI scanner “Titan Vantage” (by “Toshiba Medical Ltd”, with the field induction 1.5 Т). After this the intravenous contrast enhancement has been carried out (with 0.5 М solution, 0.2 ml/Kg), with repeat acquisition of Т1-weighted spin-echo images in 3–5 min after contrast injection. Results. MRI was employed for quantitative calculation of renal volumes of cortex, medulla and of kidney as total, as well as of suprarenal’s volume. Significant negative correlation of postoperation decrease of arterial pressure has been detected with both volume of renal cortex, as {Decrease in AP = 42.7–0.35 • (V left kidney)}, and also with mass of the right suprarenal gland as {Decrease in SAP = 16.5–6.78 • • (V right suprarenal)}. Conclusion. The anatomic quantitative data of the preoperative MRI studies of the kidneys can be employed as prognostic tool in patients referred to the renal denervation treatment of the resistant hypertension.