van Eijs Mick J M, van Zuilen Arjan D, de Boer Anneloes, Froeling Martijn, Nguyen Tri Q, Joles Jaap A, Leiner Tim, Verhaar Marianne C
Department of Nephrology and Hypertension, University Medical Center UtrechtUtrecht, Netherlands.
Department of Radiology, University Medical Center UtrechtUtrecht, Netherlands.
Front Physiol. 2017 May 16;8:296. doi: 10.3389/fphys.2017.00296. eCollection 2017.
Since the mid-1980s magnetic resonance imaging (MRI) has been investigated as a non- or minimally invasive tool to probe kidney allograft function. Despite this long-standing interest, MRI still plays a subordinate role in daily practice of transplantation nephrology. With the introduction of new functional MRI techniques, administration of exogenous gadolinium-based contrast agents has often become unnecessary and true non-invasive assessment of allograft function has become possible. This raises the question why application of MRI in the follow-up of kidney transplantation remains restricted, despite promising results. Current literature on kidney allograft MRI is mainly focused on assessment of (sub) acute kidney injury after transplantation. The aim of this review is to survey whether MRI can provide valuable diagnostic information beyond 1 year after kidney transplantation from a mechanistic point of view. The driving force behind chronic allograft nephropathy is believed to be chronic hypoxia. Based on this, techniques that visualize kidney perfusion and oxygenation, scarring, and parenchymal inflammation deserve special interest. We propose that functional MRI mechanistically provides tools for diagnostic work-up in long-term follow-up of kidney allografts.
自20世纪80年代中期以来，磁共振成像（MRI）就作为一种非侵入性或微创工具用于探测肾移植受者的肾功能。尽管长期以来人们对此兴趣浓厚，但MRI在移植肾脏病的日常实践中仍处于次要地位。随着新的功能MRI技术的引入，外源性钆基造影剂的使用常常变得不再必要，对移植肾功能进行真正的非侵入性评估也成为可能。这就引发了一个问题：尽管结果很有前景，但为什么MRI在肾移植随访中的应用仍然受限。目前关于肾移植MRI的文献主要集中在评估移植后（亚）急性肾损伤。本综述的目的是从机制角度探讨MRI在肾移植1年后是否能提供有价值的诊断信息。慢性移植肾肾病背后的驱动力被认为是慢性缺氧。基于此，能够显示肾脏灌注、氧合、瘢痕形成和实质炎症的技术值得特别关注。我们认为，功能MRI从机制上为肾移植长期随访中的诊断检查提供了工具。
