血氧水平依赖成像与弥散加权成像在动物模型急性肾损伤早期诊断中的比较。
Comparison of blood oxygen level-dependent imaging and diffusion-weighted imaging in early diagnosis of acute kidney injury in animal models.
机构信息
Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China.
Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.
出版信息
J Magn Reson Imaging. 2019 Sep;50(3):719-724. doi: 10.1002/jmri.26617. Epub 2019 Jan 11.
BACKGROUND
Early diagnosis of acute kidney injury (AKI) has clinical importance. Current methods are neither adequately sensitive nor specific. Blood oxygen level-dependent (BOLD) imaging and diffusion-weighted imaging (DWI) may help to assess AKI in the early phase.
PURPOSE
To investigate the feasibility of BOLD imaging and DWI in the assessment of AKI and compare the sensitivities of both techniques in early detection of renal damage.
STUDY TYPE
Prospective animal study.
ANIMAL MODEL
Thirty New Zealand white rabbits.
FIELD STRENGTH/SEQUENCE: 3 T clinical MRI/BOLD and DWI.
ASSESSMENT
Thirty rabbits were divided into three groups (severe AKI group, mild AKI group, and control group). Transarterial renal embolization with different doses of microspheres was performed to create severe and mild AKI disease models. All the MRI scans of kidneys were conducted within 2 hours after the embolization procedure. Histological examinations with hematoxylin and eosin staining were performed to validate renal damage.
STATISTICAL TESTS
Analysis of variance (ANOVA) for comparisons between groups, and paired t-test for tests within the same group. P < 0.05 was considered statistically significant.
RESULTS
Both R2* and apparent diffusion coefficient (ADC) showed significant differences between the severe AKI group (56.34 ± 3.45 s-1 for R2*, 1.14 ± 0.23 mm /s for ADC) and the control group (28.24 ± 2.26 s-1 for R2*, 1.94 ± 0.33 mm /s for ADC, both P < 0.01). However, the ADC values did not show significant differences (P = 0.41) between mild AKI group (1.88 ± 0.31 mm /s for ADC) and the control group (1.94 ± 0.33 mm /s for ADC), while R2* was still useful in differentiating the two groups (52.32 ± 4.1 s-1 vs. 28.24 ± 2.26 s-1 for R2*, P < 0.01). The histopathologic results were found to be correlated with MRI findings.
DATA CONCLUSION
BOLD contrast and DW images are both effective in detecting AKI noninvasively, but BOLD imaging is more sensitive in early detection of mild ischemia than DWI.
LEVEL OF EVIDENCE
1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:719-724.
背景
急性肾损伤（AKI）的早期诊断具有临床重要性。目前的方法既不够敏感也不够特异。血氧水平依赖（BOLD）成像和弥散加权成像（DWI）可能有助于在早期评估 AKI。
目的
探讨 BOLD 成像和 DWI 在 AKI 评估中的可行性，并比较两种技术在早期检测肾损伤中的敏感性。
研究类型
前瞻性动物研究。
动物模型
30 只新西兰白兔。
磁场强度/序列：3T 临床 MRI/BOLD 和 DWI。
评估
30 只兔子被分为三组（严重 AKI 组、轻度 AKI 组和对照组）。通过不同剂量的微球进行经动脉肾栓塞以建立严重和轻度 AKI 疾病模型。栓塞术后 2 小时内进行所有肾脏 MRI 扫描。进行苏木精和伊红染色的组织学检查以验证肾损伤。
统计学检验
组间比较采用方差分析（ANOVA），组内比较采用配对 t 检验。P<0.05 被认为具有统计学意义。
结果
严重 AKI 组（R2为 56.34±3.45 s-1，ADC 为 1.14±0.23 mm /s）和对照组（R2为 28.24±2.26 s-1，ADC 为 1.94±0.33 mm /s）之间的 R2和表观扩散系数（ADC）均显示出显著差异（均 P<0.01）。然而，轻度 AKI 组（ADC 为 1.88±0.31 mm /s）和对照组（ADC 为 1.94±0.33 mm /s）之间的 ADC 值没有显示出显著差异（P=0.41），而 R2仍然可以区分两组（R2*分别为 52.32±4.1 s-1 和 28.24±2.26 s-1，均 P<0.01）。组织病理学结果与 MRI 发现相关。
数据结论
BOLD 对比和 DW 图像都是检测 AKI 的有效方法，但 BOLD 成像在早期检测轻度缺血方面比 DWI 更敏感。
证据水平
1 技术功效：第 2 阶段 J. Magn. Reson. Imaging 2019;50:719-724.
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