Institute of Clinical Medicine, Aarhus University Hospital, Denmark.
Z Med Phys. 2010;20(2):115-21. doi: 10.1016/j.zemedi.2010.01.004. Epub 2010 Mar 10.
This MRI study demonstrates our first clinical experiences with structural and functional evaluation in children with renal dysfunction, and communicates our experience with quantitative measurements of renal function compared to reference values found employing radionucleotides.
We included renal impaired children who were recruited for clinical radioisotopic GFR measurements (n=8). MRI was performed 2 hours after Cr-EDTA measurements and was conducted using a protocol involving both anatomical/structural sequences and a dynamic contrast-enhanced sequence. Data obtained with the dynamic MRI sequence were processed using the graphical Patlak approach to obtain estimates of GFR.
We were able to characterize the intrarenal configuration (cortex, medulla, pelvicalyceal arrangement) in all cases. Functional analyses of dynamic contrast-enhanced MRI revealed an overall underestimation of GFR measured by MRI compared to Cr-EDTPA measures (range: -2% to -43%).
We advocate the use of MRI as a single-modality approach in the structural and functional evaluation of impaired kidneys in children, and concurrently, we presented a clinically available strategy for estimations of renal cortical volume and single kidney function. However, the use of MRI contrast agents have recently become controversial in renal patients due to the risk of NSF.
本 MRI 研究展示了我们在肾功能障碍儿童的结构和功能评估方面的初步临床经验，并交流了我们在与放射性核素相比的肾功能定量测量方面的经验。
我们纳入了因临床放射性同位素 GFR 测量而招募的肾功能受损儿童（n=8）。MRI 在 Cr-EDTA 测量后 2 小时进行，使用包含解剖/结构序列和动态对比增强序列的方案进行。使用动态 MRI 序列获得的数据采用图形 Patlak 方法进行处理，以获得 GFR 的估计值。
我们能够在所有病例中描绘出肾内结构（皮质、髓质、肾盂排列）。动态对比增强 MRI 的功能分析显示，与 Cr-EDTPA 测量相比，MRI 测量的 GFR 总体低估（范围：-2%至-43%）。
我们主张在儿童受损肾脏的结构和功能评估中使用 MRI 作为单一模态方法，并同时提出了一种临床可用的估计肾皮质体积和单肾功能的策略。然而，由于 NSF 的风险，MRI 造影剂在肾功能障碍患者中的应用最近变得备受争议。
