von Stillfried Saskia, Apitzsch Jonas C, Ehling Josef, Penzkofer Tobias, Mahnken Andreas H, Knüchel Ruth, Floege Jürgen, Boor Peter
Institute of Pathology, Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany.
Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Aachen, Germany.
Angiogenesis. 2016 Oct;19(4):525-35. doi: 10.1007/s10456-016-9524-7. Epub 2016 Aug 31.
Renal microvascular rarefaction characterizes chronic kidney disease (CKD). In murine models of CKD, micro-CT imaging reflected capillary rarefaction using quantification of renal relative blood volume (rBV). In addition, micro-CT imaging revealed morphological alterations of the intrarenal vasculature including reduced vascular branching and lumen diameter. Here, we retrospectively quantified rBV in contrast-enhanced CT angiography in patients and found that, compared to non-CKD patients, those with CKD and renal fibrosis had significantly reduced rBV in the renal cortex. rBV values closely mirrored capillary rarefaction in the corresponding nephrectomy specimens. In patients with follow-up CT angiography, reduction of renal function was paralleled by a decline in rBV. Using virtual autopsy, i.e., postmortem CT angiography, morphometry of intrarenal arteries in 3D-rendered CT images revealed significantly reduced arterial diameter and branching in CKD compared to non-CKD cases. In conclusion, in CKD patients, contrast-enhanced CT imaging with quantification of rBV correlates with functional renal vasculature, whereas virtual autopsy allows morphometric analyses of macrovascular changes. Importantly, the observed vascular alterations in CKD patients mirror those in animals with progressive CKD, suggesting a high relevance of animal models for studying vascular alterations in CKD and renal fibrosis.
肾微血管稀疏是慢性肾脏病（CKD）的特征。在CKD小鼠模型中，显微CT成像通过对肾相对血容量（rBV）的量化反映了毛细血管稀疏。此外，显微CT成像还揭示了肾内血管系统的形态学改变，包括血管分支减少和管腔直径减小。在此，我们回顾性地对患者的对比增强CT血管造影中的rBV进行了量化，发现与非CKD患者相比，患有CKD和肾纤维化的患者肾皮质中的rBV显著降低。rBV值与相应肾切除标本中的毛细血管稀疏密切相关。在接受随访CT血管造影的患者中，肾功能的降低与rBV的下降同时出现。使用虚拟尸检，即死后CT血管造影，在三维重建的CT图像中对肾内动脉进行形态测量，结果显示与非CKD病例相比，CKD患者的动脉直径和分支显著减少。总之，在CKD患者中，通过对rBV进行量化的对比增强CT成像与功能性肾血管系统相关，而虚拟尸检则允许对大血管变化进行形态测量分析。重要的是，在CKD患者中观察到的血管改变与进行性CKD动物中的改变相似，这表明动物模型对于研究CKD和肾纤维化中的血管改变具有高度相关性。
