Haneder S, Boda-Heggemann J, Schoenberg S O, Michaely H J
Institut für Klinische Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim.
Radiologe. 2012 Mar;52(3):243-51. doi: 10.1007/s00117-011-2195-x.
The diagnosis of radiation-induced (especially chronic) renal alterations/damage is difficult and currently relies primarily on clinical evaluation. The importance of renal diagnostic evaluation will increase continuously due to the increasing number of long-term survivors after radiotherapy. This article evaluates the potentia diagnostic contribution of magnetic resonance (MR) imaging with a focus on functional MRI. The following functional MRI approaches are briefly presented and evaluated: blood oxygenation level-dependent imaging (BOLD), diffusion-weighted imaging (DWI) or diffusion tensor imaging (DTI), MR perfusion measurements and (23)Na imaging. In summary, only DWI and contrast-enhanced MR perfusion currently seem to be suitable approaches for a broader, clinical implementation. However, up to now valid data from larger patient studies are lacking for both techniques in regard to radiation-induced renal alterations. The BOLD and (23)Na imaging procedures have a huge potential but are currently neither sufficiently evaluated with regard to radiation-induced renal alterations nor technically simple and reliable for implementation into the clinical routine.
辐射诱导（尤其是慢性）肾脏改变/损伤的诊断很困难，目前主要依赖临床评估。由于放疗后长期存活者数量不断增加，肾脏诊断评估的重要性将持续上升。本文评估了磁共振（MR）成像，尤其是功能磁共振成像的潜在诊断价值。简要介绍并评估了以下功能磁共振成像方法：血氧水平依赖性功能磁共振成像（BOLD）、扩散加权成像（DWI）或扩散张量成像（DTI）、MR灌注测量以及（23）Na成像。总之，目前只有DWI和对比增强MR灌注似乎适合更广泛地应用于临床。然而，就辐射诱导的肾脏改变而言，目前这两种技术都缺乏来自大型患者研究的有效数据。BOLD和（23）Na成像程序具有巨大潜力，但目前对于辐射诱导的肾脏改变既没有得到充分评估，在技术上也不够简单可靠，无法应用于临床常规。
