Del Maschio A, Sironi S, Rodighiero M, Cucchi E, Mellone R, Staudacher C, Di Carlo V, Secchi A, Pozza G
Radiologia Diagnostica, Istituto Scientifico H S. Raffaele, Milano.
Radiol Med. 1989 Oct;78(4):324-8.
Graft rejection is the major cause of graft loss following pancreatic transplantation. Early detection of the rejection process is of great importance towards planning effective treatment when transplant recipients present with aspecific clinical findings suggesting rejection. Up to date, the demonstration of pancreatic transplant rejection has been attempted with nuclear medicine and sonography (US). The authors studied high-field (1.5 T) MR potentials in pancreatic transplantation and rejection and correlated MR findings with clinical and laboratory data. Eleven MR scans were obtained from 4 patients with suspected pancreatic graft rejection, and 9 MR images from 4 patients with normal pancreatic allografts. Qualitative image evaluation showed the pancreatic tissue of the patients diagnosed with rejection to be hypointense on T1-weighted scans and highly hyperintense on T2-weighted scans, as compared to normal grafts. Quantitative data were obtained by comparing the signal intensity of pancreatic grafts to that of the nearby muscle. On both T1- and T2-weighted images, pancreatic tissue/muscle signal-intensity ratios were significantly different, in rejecting transplants, from those of normal allografts (p less than 0.001). Our qualitative and quantitative findings suggest the use of MR imaging as a reliable means of detecting pancreatic graft rejection.
移植排斥是胰腺移植后移植物丢失的主要原因。当移植受者出现提示排斥的非特异性临床症状时，尽早发现排斥过程对于规划有效的治疗至关重要。到目前为止，人们一直试图通过核医学和超声检查（US）来证实胰腺移植排斥反应。作者研究了高场强（1.5T）磁共振成像在胰腺移植和排斥反应中的应用，并将磁共振成像结果与临床和实验室数据进行了关联。对4例疑似胰腺移植排斥患者进行了11次磁共振扫描，对4例胰腺移植正常的患者进行了9次磁共振成像。定性图像评估显示，与正常移植物相比，诊断为排斥反应的患者的胰腺组织在T1加权扫描上呈低信号，在T2加权扫描上呈高信号。通过比较胰腺移植物与附近肌肉的信号强度获得定量数据。在T1加权和T2加权图像上，排斥移植的胰腺组织/肌肉信号强度比值与正常同种异体移植物的比值均有显著差异（p<0.001）。我们的定性和定量研究结果表明，磁共振成像可作为检测胰腺移植排斥反应的可靠手段。
