Park Jonathan K, Rhee Thomas K, Cashen Ty A, Shin Wanyong, Schirf Brian E, Gehl James A, Larson Andrew C, Prasad Pottumarthi V, Li Debiao, Carroll Timothy J, Omary Reed A
Department of Radiology, Northwestern University Feinberg School of Medicine, 448 E Ontario St, Suite 700, Chicago, IL 60611, USA.
Radiology. 2007 Jul;244(1):144-50. doi: 10.1148/radiol.2433060184. Epub 2007 May 10.
To prospectively test--in a swine model of renal artery stenosis (RAS)--the hypothesis that magnetic resonance (MR) imaging can reveal changes in renal function at the time of percutaneous transluminal angioplasty (PTA).
In this animal care and use committee-approved study, high-grade unilateral RAS was surgically induced in six pigs. MR imaging at 3.0 T was used for intraprocedural assessment of the anatomic and physiologic changes induced by x-ray-guided PTA. With use of MR imaging, changes in single-kidney glomerular filtration rate, extraction fraction, and renal blood flow were assessed during PTA. The arterial diameter of stenosis before and after PTA was assessed by using conventional digital subtraction angiography. Mean changes in functional and anatomic parameters were compared by using the Wilcoxon signed rank test (alpha = .05).
At digital subtraction angiography, the mean percentage of stenosis was 69% +/- 10 (standard deviation) before PTA and 26% +/- 10 after PTA (P<.03). Mean pre- and post-PTA extraction fraction values were 0.11 +/- 0.03 and 0.19 +/- 0.06, respectively (P<.03). The mean single-kidney glomerular filtration rate before PTA, 19 mL/min +/- 13, increased to 41 mL/min +/- 33 after PTA (P<.03). There was no significant change in mean renal blood flow after PTA (P=.44).
In swine, MR imaging can reveal changes in renal function after x-ray-guided PTA for unilateral RAS.
在猪肾动脉狭窄（RAS）模型中进行前瞻性试验，以验证磁共振（MR）成像能否在经皮腔内血管成形术（PTA）时揭示肾功能变化这一假设。
在这项经动物护理和使用委员会批准的研究中，通过手术在六头猪身上诱发了重度单侧RAS。使用3.0 T的MR成像对X线引导下PTA引起的解剖和生理变化进行术中评估。利用MR成像，在PTA过程中评估单肾肾小球滤过率、提取分数和肾血流量的变化。通过传统数字减影血管造影评估PTA前后狭窄的动脉直径。使用Wilcoxon符号秩检验（α = 0.05）比较功能和解剖参数的平均变化。
在数字减影血管造影中，PTA前狭窄的平均百分比为69%±10（标准差），PTA后为26%±10（P<0.03）。PTA前后提取分数的平均预估值分别为0.11±0.03和0.19±0.06（P<0.03）。PTA前单肾肾小球滤过率平均为19 mL/min±13，PTA后增至41 mL/min±33（P<0.03）。PTA后肾血流量平均值无显著变化（P = 0.44）。
在猪中，MR成像可揭示X线引导下单侧RAS进行PTA后肾功能的变化。
