肾脏疾病的肾脏定量 MRI。
Quantitative MRI of kidneys in renal disease.
机构信息
Department of Radiology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, 55905, MN, USA.
Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA.
出版信息
Abdom Radiol (NY). 2018 Mar;43(3):629-638. doi: 10.1007/s00261-017-1236-y.
PURPOSE
To evaluate the reproducibility and utility of quantitative magnetic resonance imaging (MRI) sequences for the assessment of kidneys in young adults with normal renal function (eGFR ranged from 90 to 130 mL/min/1.73 m) and patients with early renal disease (autosomal dominant polycystic kidney disease).
MATERIALS AND METHODS
This prospective case-control study was performed on ten normal young adults (18-30 years old) and ten age- and sex-matched patients with early renal parenchymal disease (autosomal dominant polycystic kidney disease). All subjects underwent a comprehensive kidney MRI protocol, including qualitative imaging: T1w, T2w, FIESTA, and quantitative imaging: 2D cine phase contrast of the renal arteries, and parenchymal diffusion weighted imaging (DWI), magnetization transfer imaging (MTI), blood oxygen level dependent (BOLD) imaging, and magnetic resonance elastography (MRE). The normal controls were imaged on two separate occasions ≥24 h apart (range 24-210 h) to assess reproducibility of the measurements.
RESULTS
Quantitative MR imaging sequences were found to be reproducible. The mean ± SD absolute percent difference between quantitative parameters measured ≥24 h apart were: MTI-derived ratio = 4.5 ± 3.6%, DWI-derived apparent diffusion coefficient (ADC) = 6.5 ± 3.4%, BOLD-derived R2* = 7.4 ± 5.9%, and MRE-derived tissue stiffness = 7.6 ± 3.3%. Compared with controls, the ADPKD patient's non-cystic renal parenchyma (NCRP) had statistically significant differences with regard to quantitative parenchymal measures: lower MTI percent ratios (16.3 ± 4.4 vs. 23.8 ± 1.2, p < 0.05), higher ADCs (2.46 ± 0.20 vs. 2.18 ± 0.10 × 10 mm/s, p < 0.05), lower R2*s (14.9 ± 1.7 vs. 18.1 ± 1.6 s, p < 0.05), and lower tissue stiffness (3.2 ± 0.3 vs. 3.8 ± 0.5 kPa, p < 0.05).
CONCLUSION
Excellent reproducibility of the quantitative measurements was obtained in all cases. Significantly different quantitative MR parenchymal measurement parameters between ADPKD patients and normal controls were obtained by MT, DWI, BOLD, and MRE indicating the potential for detecting and following renal disease at an earlier stage than the conventional qualitative imaging techniques.
目的
评估定量磁共振成像（MRI）序列在评估肾功能正常（eGFR 范围为 90 至 130 mL/min/1.73 m）的年轻成年人和早期肾病（常染色体显性多囊肾病）患者的肾脏方面的可重复性和实用性。
材料和方法
本前瞻性病例对照研究纳入了 10 名年龄在 18-30 岁之间的肾功能正常的年轻成年人（正常对照组）和 10 名年龄和性别匹配的早期肾实质疾病（常染色体显性多囊肾病）患者。所有患者均接受了全面的肾脏 MRI 方案，包括定性成像：T1w、T2w、FIESTA 和定量成像：肾动脉二维电影相位对比、肾实质弥散加权成像（DWI）、磁化传递成像（MTI）、血氧水平依赖（BOLD）成像和磁共振弹性成像（MRE）。正常对照组在至少 24 小时（范围 24-210 小时）内进行两次独立成像，以评估测量值的可重复性。
结果
发现定量 MRI 序列具有可重复性。定量参数在至少 24 小时后测量的平均绝对百分比差异（±标准差）为：MTI 衍生比值=4.5±3.6%，DWI 衍生表观扩散系数（ADC）=6.5±3.4%，BOLD 衍生 R2*=7.4±5.9%，MRE 衍生组织硬度=7.6±3.3%。与对照组相比，ADPKD 患者的非囊性肾实质（NCRP）在定量实质测量方面有统计学显著差异：MTI 百分比比值较低（16.3±4.4 与 23.8±1.2，p<0.05），ADC 较高（2.46±0.20 与 2.18±0.10×10 mm/s，p<0.05），R2*较低（14.9±1.7 与 18.1±1.6 s，p<0.05），组织硬度较低（3.2±0.3 与 3.8±0.5 kPa，p<0.05）。
结论
在所有病例中均获得了定量测量的极好可重复性。通过 MTI、DWI、BOLD 和 MRE 获得了 ADPKD 患者和正常对照组之间的显著不同的定量 MR 实质测量参数，表明与常规定性成像技术相比，有潜力在更早阶段检测和随访肾脏疾病。
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