Frank J A, Choyke P L, Girton M E, Austin H A, Sievenpiper C, Inscoe S W, Black J L, Carvlin M J, Dwyer A J
Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892.
J Comput Assist Tomogr. 1989 May-Jun;13(3):448-59. doi: 10.1097/00004728-198905000-00016.
Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) enhanced dynamic magnetic resonance (MR) imaging was used to monitor the nephrotoxic effects of cis-platinum (cis-diamminedichloroplatinum; CDDP), a chemotherapeutic agent that produces damage in the proximal convoluted tubule. Ten New Zealand white rabbits (NZWs) were divided into two groups and were evaluated at two clinically relevant doses of CDDP. Group 1 (four NZWs) received CDDP intravenously at 125 mg/m2 over 1 h. Rabbits in Group 2 (six NZWs) were infused with CDDP at 40 mg/m2 each day for 5 consecutive days. Dynamic MR images were performed in the axial plane at 1.5 T using a gradient recalled acquisition in the steady state sequence with an echo time of 11 ms, a repetition time of 20 ms, and a flip angle of 10 degrees after a bolus injection of Gd-DTPA 0.1 mmol/kg. Thirty-two sequential post Gd-DTPA images (5.12 s/image) were obtained over 2 min 45 s at a single location. All rabbits underwent baseline normal and serial post CDDP Gd-DTPA enhanced dynamic MR scans. Analysis of the alterations in the normal pattern of renal enhancement caused by CDDP was facilitated by using a stacked profile image and quantitative region of interest measurements of signal intensity. Normally, after the injection of Gd-DTPA, a dark band promptly appears in the outer cortex of the kidneys and migrates centripetally toward the papilla, reflecting the tubular concentration of Gd-DTPA. In Group 1 rabbits, nephrotoxicity due to CDDP was observed as early as 9 h after administration of the drug, with a complete disappearance of the dark band by 7 days. In Group 2 rabbits, the band disappeared gradually and reappeared 2-10 days after the completion of CDDP treatment, indicative of tubular damage and recovery with return of the concentrating ability of the kidney. These results illustrate the feasibility of using Gd-DTPA dynamic MR as a sensitive monitor of drug induced alterations of renal function.
钆喷酸葡胺（Gd-DTPA）增强动态磁共振（MR）成像用于监测顺铂（顺二氯二氨铂；CDDP）的肾毒性作用，顺铂是一种对近端曲管产生损伤的化疗药物。将10只新西兰白兔（NZW）分为两组，并在两种临床相关剂量的CDDP下进行评估。第1组（4只NZW）在1小时内静脉注射125mg/m²的CDDP。第2组（6只NZW）的兔子连续5天每天输注40mg/m²的CDDP。在1.5T下使用稳态序列中的梯度回波采集在轴平面上进行动态MR成像，回波时间为11ms，重复时间为20ms，在静脉注射0.1mmol/kg的Gd-DTPA后翻转角为10度。在2分45秒内在单个位置获得32幅连续的Gd-DTPA后图像（5.12秒/幅）。所有兔子均接受基线正常和CDDP后连续的Gd-DTPA增强动态MR扫描。通过使用叠加轮廓图像和信号强度的定量感兴趣区域测量，便于分析由CDDP引起的肾脏增强正常模式的改变。通常，注射Gd-DTPA后，肾脏外皮质会立即出现一条暗带，并向乳头向心性迁移，反映了Gd-DTPA的肾小管浓度。在第1组兔子中，在给药后9小时就观察到了CDDP引起的肾毒性，到7天时暗带完全消失。在第2组兔子中，暗带逐渐消失，并在CDDP治疗完成后2-10天重新出现，这表明肾小管损伤并随着肾脏浓缩能力的恢复而恢复。这些结果说明了使用Gd-DTPA动态MR作为药物诱导的肾功能改变的敏感监测方法的可行性。
