Kanki Akihiko, Ito Katsuyoshi, Yamamoto Akira, Yasokawa Kazuya, Noda Yasufumi, Sato Tomohiro, Tamada Tsutomu
Department of Radiology, Kawasaki Medical School, Kurashiki, Japan.
Br J Radiol. 2016 Aug;89(1064):20150803. doi: 10.1259/bjr.20150803. Epub 2016 May 25.
: To compare renal cortical thicknesses between patients with and without cirrhosis with normal renal function based on serum creatinine using non-contrast-enhanced steady-state, free precession (SSFP) MRI with spatially selective inversion recovery (IR) pulses and to discuss the clinical implications of measuring renal cortical thickness in patients with cirrhosis.
: 40 patients with and without cirrhosis who had normal renal function based on serum creatinine and underwent non-contrast-enhanced SSFP imaging with spatially selective IR pulses were included. The renal cortical thickness, renal width, renal cortical width ratio, serum creatinine levels and estimated glomerular filtration rates (eGFRs) were compared between cirrhotic and non-cirrhotic groups.
: The mean renal cortical thickness was significantly lower in the cirrhotic group (3.6 ± 0.9 mm) than in the non-cirrhotic group (4.9 ± 0.8 mm; p < 0.001). The mean renal cortical width ratio was significantly lower in the cirrhotic group (0.07 ± 0.02) than in the non-cirrhotic group (0.10 ± 0.02; p < 0.001). The mean serum creatinine and mean eGFR did not show significant differences between the two groups.
: Measurement of renal cortical thickness by means of non-contrast-enhanced SSFP MRI with spatially selective IR pulses may help evaluate renal function accurately in patients with cirrhosis, in whom it may be overestimated by serum creatinine and eGFR.
: (1) The renal corticomedullary junction was clearly depicted by non-contrast-enhanced SSFP MRI with spatially selective IR pulses in all patients with and without cirrhosis. (2) The mean renal cortical thickness measured on the optimal SSFP image with spatially selective IR pulses was significantly lower in the cirrhotic group (3.6 ± 1.0 mm) than in the non-cirrhotic group (4.9 ± 0.8 mm) (p < 0.001), although the mean eGFR did not show a significant difference between the two groups.
使用具有空间选择性反转恢复（IR）脉冲的非增强稳态自由进动（SSFP）磁共振成像（MRI），比较基于血清肌酐的肾功能正常的肝硬化患者和非肝硬化患者的肾皮质厚度，并探讨测量肝硬化患者肾皮质厚度的临床意义。
纳入40例基于血清肌酐肾功能正常且接受了具有空间选择性IR脉冲的非增强SSFP成像的肝硬化患者和非肝硬化患者。比较肝硬化组和非肝硬化组之间的肾皮质厚度、肾宽度、肾皮质宽度比、血清肌酐水平和估计肾小球滤过率（eGFR）。
肝硬化组的平均肾皮质厚度（3.6±0.9mm）显著低于非肝硬化组（4.9±0.8mm；p<0.001）。肝硬化组的平均肾皮质宽度比（0.07±0.02）显著低于非肝硬化组（0.10±0.02；p<0.001）。两组之间的平均血清肌酐和平均eGFR没有显著差异。
通过具有空间选择性IR脉冲的非增强SSFP MRI测量肾皮质厚度，可能有助于准确评估肝硬化患者的肾功能，因为血清肌酐和eGFR可能会高估这些患者的肾功能。
（1）在所有肝硬化患者和非肝硬化患者中，具有空间选择性IR脉冲的非增强SSFP MRI均清晰显示了肾皮质髓质交界。（2）在具有空间选择性IR脉冲的最佳SSFP图像上测量的平均肾皮质厚度，肝硬化组（3.6±1.0mm）显著低于非肝硬化组（4.9±0.8mm）（p<0.001），尽管两组之间的平均eGFR没有显著差异。
