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肾移植后使用磁共振扩散张量成像进行排斥反应评估。

Rejection evaluation after renal transplantation using MR diffusion tensor imaging.

作者信息

Deger Emin, Celik Azim, Dheir Hamad, Turunc Volkan, Yardimci Ahmet, Torun Mert, Cihangiroglu Mutlu

机构信息

1 Department of Radiology, Medicalpark Goztepe Hospital, Istanbul, Turkey.

2 GE Healthcare Istanbul, Istanbul, Turkey.

出版信息

Acta Radiol. 2018 Jul;59(7):876-883. doi: 10.1177/0284185117733777. Epub 2017 Oct 4.

Abstract

Background Renal allograft dysfunction monitoring is mainly performed using the serum creatinine (SC) level, Doppler ultrasound (US), or renal biopsy. Recently proposed diffusion-based magnetic resonance imaging (MRI) methods have been explored as new, non-invasive tools for assessing renal function after transplantation. Purpose To investigate the value of fractional anisotropy (FA) measurements in the evaluation of acute rejection cases after renal transplant. Material and Methods Doppler US and MRI diffusion tensor imaging (DTI) were performed in 21 patients with graft dysfunction requiring graft biopsy after renal transplantation and in 21 patients with normal graft function. The MR examinations were performed on a 1.5-T MRI using two b-values (0 and 800 s/mm). FA values were measured from the cortex and medulla of the transplanted kidney at the upper, middle, and lower poles. Results Twenty-one transplant patients diagnosed with acute rejection (Group 1) were compared to the control group of 21 transplant patients with normal graft function (Group 2). The measured FA values of the medulla were 0.19 ± 0.02 and 0.22 ± 0.05 ( P = 0.017) for Groups 1 and 2, respectively. On the other hand, the measured FA values of the renal cortex were 0.18 ± 0.04 and 0.18 ± 0.04 ( P = 0.97) for Groups 1 and 2, respectively. Conclusion The good correlation between the renal medulla FA values and allograft function shows that MR DTI has potential for non-invasive functional assessment of transplanted kidneys. On the other hand, the renal cortex FA values had no correlation with the allograft function.

摘要

背景 肾移植功能障碍监测主要通过血清肌酐(SC)水平、多普勒超声(US)或肾活检来进行。最近提出的基于扩散的磁共振成像(MRI)方法已被探索作为评估移植后肾功能的新型非侵入性工具。目的 探讨分数各向异性(FA)测量在评估肾移植后急性排斥反应病例中的价值。材料与方法 对21例肾移植后出现移植功能障碍需要进行移植肾活检的患者以及21例移植肾功能正常的患者进行了多普勒超声和MRI扩散张量成像(DTI)检查。MR检查在1.5-T MRI上使用两个b值(0和800 s/mm²)进行。在移植肾的上极、中极和下极的皮质和髓质测量FA值。结果 将21例诊断为急性排斥反应的移植患者(第1组)与21例移植肾功能正常的对照组患者(第2组)进行比较。第1组和第2组髓质的测量FA值分别为0.19±0.02和0.22±0.05(P = 0.017)。另一方面,第1组和第2组肾皮质的测量FA值分别为0.18±0.04和0.18±0.04(P = 0.97)。结论 肾髓质FA值与移植肾功能之间的良好相关性表明,MR DTI在移植肾的非侵入性功能评估方面具有潜力。另一方面,肾皮质FA值与移植肾功能无关。

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