Zhou Hai Ying, Chen Tian Wu, Zhang Xiao Ming
Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63 Wenhua Road, Shunqing District, Nanchong, Sichuan 637000, China.
Biomed Res Int. 2016;2016:2027370. doi: 10.1155/2016/2027370. Epub 2016 Jan 26.
Acute kidney injury (AKI) is a common complication of hospitalization that is characterized by a sudden loss of renal excretory function and associated with the subsequent development of chronic kidney disease, poor prognosis, and increased mortality. Although the pathophysiology of renal functional impairment in the setting of AKI remains poorly understood, previous studies have identified changes in renal hemodynamics, perfusion, and oxygenation as key factors in the development and progression of AKI. The early assessment of these changes remains a challenge. Many established approaches are not applicable to humans because of their invasiveness. Functional renal magnetic resonance (MR) imaging offers an alternative assessment tool that could be used to evaluate renal morphology and function noninvasively and simultaneously. Thus, the purpose of this review is to illustrate the principle, application, and role of the techniques of functional renal MR imaging, including blood oxygen level-dependent imaging, arterial spin labeling, and diffusion-weighted MR imaging, in the management of AKI. The use of gadolinium in MR imaging may exacerbate renal impairment and cause nephrogenic systemic fibrosis. Therefore, dynamic contrast-enhanced MR imaging will not be discussed in this paper.
急性肾损伤（AKI）是住院治疗中常见的并发症，其特征为肾功能突然丧失，并与随后慢性肾脏病的发生、预后不良及死亡率增加相关。尽管在AKI情况下肾功能损害的病理生理学仍知之甚少，但先前的研究已确定肾血流动力学、灌注和氧合的变化是AKI发生和发展的关键因素。对这些变化的早期评估仍然是一项挑战。许多既定方法因其侵入性而不适用于人类。功能性肾脏磁共振（MR）成像提供了一种替代评估工具，可用于无创且同时地评估肾脏形态和功能。因此，本综述的目的是阐述功能性肾脏MR成像技术，包括血氧水平依赖性功能磁共振成像、动脉自旋标记和扩散加权磁共振成像，在AKI管理中的原理、应用及作用。磁共振成像中钆的使用可能会加重肾功能损害并导致肾源性系统性纤维化。因此，本文将不讨论动态对比增强磁共振成像。
