From the Departments of Radiology and Clinical Research, University of Bern, AMSM (DKF-DIPR), Pavilion 52A Inselspital, PO Box 35, CH-3010 Bern, Switzerland (M.S., T.B., F.K., A.R., C.B., P.V.); Department of Nephrology, University Hospital Essen-Duisburg, Essen, Germany (U.E.); Department of Radiology, Neuroradiology and Nuclear Medicine (H.C.T.) and Department of Nephrology, Hypertension and Clinical Pharmacology (B.V.), University Hospital of Bern, Switzerland.
Radiology. 2016 Jun;279(3):795-804. doi: 10.1148/radiol.2015150370. Epub 2016 Jan 8.
Purpose To determine renal oxygenation changes associated with uninephrectomy and transplantation in both native donor kidneys and transplanted kidneys by using blood oxygenation level-dependent (BOLD) MR imaging. Materials and Methods The study protocol was approved by the local ethics committee. Thirteen healthy kidney donors and their corresponding recipients underwent kidney BOLD MR imaging with a 3-T imager. Written informed consent was obtained from each subject. BOLD MR imaging was performed in donors before uninephrectomy and in donors and recipients 8 days, 3 months, and 12 months after transplantation. R2* values, which are inversely related to tissue partial pressure of oxygen, were determined in the cortex and medulla. Longitudinal R2* changes were statistically analyzed by using repeated measures one-way analysis of variance with post hoc pair-wise comparisons. Results R2* values in the remaining kidneys significantly decreased early after uninephrectomy in both the medulla and cortex (P < .003), from 28.9 sec(-1) ± 2.3 to 26.4 sec(-1) ± 2.5 in the medulla and from 18.3 sec(-1) ± 1.5 to 16.3 sec(-1) ± 1.0 in the cortex, indicating increased oxygen content. In donors, R2* remained significantly decreased in both the medulla and cortex at 3 (P < .01) and 12 (P < .01) months. In transplanted kidneys, R2* remained stable during the first year after transplantation, with no significant change. Among donors, cortical R2* was found to be negatively correlated with estimated glomerular filtration rate (R = -0.47, P < .001). Conclusion The results suggest that BOLD MR imaging may potentially be used to monitor renal functional changes in both remaining and corresponding transplanted kidneys. (©) RSNA, 2016.
目的 通过血氧水平依赖(BOLD)磁共振成像(MRI),确定在同种异体供肾和移植肾中,与单侧肾切除和移植相关的肾氧合变化。
材料与方法 本研究方案获得了当地伦理委员会的批准。13 名健康的供肾者及其对应的受者在 3.0T 磁共振扫描仪上进行了肾 BOLD MRI 检查。每位受检者均签署了书面知情同意书。供者在单侧肾切除术前,以及术后 8 天、3 个月和 12 个月进行 BOLD MRI 检查。在皮髓质中测定与组织氧分压呈反比的 R2值。采用重复测量单向方差分析对纵向 R2变化进行统计学分析,并进行事后两两比较。
结果 单侧肾切除术后早期,供者的肾髓质和皮质 R2值均显著降低(P <.003),分别从 28.9 sec(-1) ± 2.3 降至 26.4 sec(-1) ± 2.5 和从 18.3 sec(-1) ± 1.5 降至 16.3 sec(-1) ± 1.0,表明氧含量增加。在供者中,3 个月(P <.01)和 12 个月(P <.01)时,肾髓质和皮质的 R2仍显著降低。在移植肾中,移植术后 1 年内 R2保持稳定,无显著变化。在供者中,皮质 R2与估算肾小球滤过率(R = -0.47,P <.001)呈负相关。
结论 BOLD MRI 可能有助于监测剩余和相应移植肾的肾功能变化。
(©)2016 RSNA。