Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, China.
Eur J Radiol. 2012 May;81(5):838-45. doi: 10.1016/j.ejrad.2011.02.041. Epub 2011 Mar 10.
In this study, we evaluated a large number of subjects using BOLD MRI to provide more information about oxygen metabolism in the normal function of transplanted kidneys and to distinguish acute graft rejection from normal function kidneys. This study included 122 subjects (20 volunteers, 72 patients with normal functioning transplants, and 21 patients with acute rejection), and 9 patients had normal function grafts received examination while grafts dysfunction occurred within 6 months during the follow-up. The R2 (1/s) values in the cortex and medulla as well as the R2 ratio of the medulla to cortex (R2 ratio of M/C) were recorded. The R2 values of the medulla were higher than those of the cortex in the normal function group and the volunteers which have a steep R2 ratio of M/C. All the R2 values in the acute rejection group were lower than those in the normal function grafts group (P<0.001). Moreover, in the 9 patients as normal function, the R2 values of the cortex and medulla were different from the normal function grafts, which was lower in 5 patients and was higher in the 4 remaining patients. Conversely, the R2 ratios of M/C of the 9 patients were similar to those in the normal function group. BOLD MRI shows that decreased R2 values of the cortex and medulla and R2 ratio of M/C suggest acute renal graft rejection; furthermore, a steep R2 ratio of M/C (>1.1) is an important reason for keeping clinical normal function.
在这项研究中，我们使用 BOLD MRI 评估了大量受试者，以提供更多关于移植肾正常功能中氧代谢的信息，并将急性移植物排斥反应与正常功能肾区分开来。本研究共纳入 122 例受试者（20 名志愿者、72 名移植肾功能正常患者和 21 名急性排斥反应患者），其中 9 例移植肾功能正常患者在随访期间 6 个月内发生移植物功能障碍时接受了检查。记录皮质和髓质的 R2（1/s）值以及髓质与皮质的 R2 比值（M/C 的 R2 比值）。正常功能组和志愿者组的髓质 R2 值高于皮质，M/C 的 R2 比值陡峭。急性排斥反应组的所有 R2 值均低于正常功能移植物组（P<0.001）。此外，在 9 例正常功能患者中，皮质和髓质的 R2 值与正常功能移植物不同，其中 5 例患者较低，4 例患者较高。相反，9 例患者的 M/C 的 R2 比值与正常功能组相似。BOLD MRI 显示，皮质和髓质的 R2 值降低以及 M/C 的 R2 比值降低提示急性肾移植排斥反应；此外，陡峭的 M/C 的 R2 比值（>1.1）是保持临床正常功能的重要原因。
