Baumgartner B R, Nelson R C, Ball T I, Wyly J B, Bourke E, Delaney V, Bernardino M E
AJR Am J Roentgenol. 1986 Nov;147(5):949-53. doi: 10.2214/ajr.147.5.949.
Fifty-six MR studies were obtained in 32 renal transplant patients, by using T1-weighted, spin-echo, and inversion-recovery pulse sequences. The findings, particularly the loss of corticomedullary differentiation, and the extent of vascular penetration into the renal parenchyma, were compared with the clinical and histologic diagnosis of transplant rejection. Thirteen MR studies on 11 patients with clinically normal renal transplants demonstrated normal corticomedullary differentiation. Renal vessels extended into the parenchyma in all 11 patients and to the cortex in 38%. In 37 MR studies on 22 patients with a clinical or histologic diagnosis of acute and/or chronic transplant rejection, the corticomedullary differentiation was normal in 8%, faint in 24%, and absent in 68%. Renal parenchymal vessels were visualized in 32%, but extended to the level of the cortex in only 8%. In 68% of the studies with transplant rejection, no parenchymal vessels were seen. When the corticomedullary differentiation was either faint or absent, the vascular pattern was normal in 6%; in 68% of cases no parenchymal vessels could be identified. We conclude the corticomedullary differentiation and the renal vascular pattern are useful parameters in the evaluation of renal transplant rejection.
对32例肾移植患者进行了56次磁共振成像（MR）检查，采用T1加权、自旋回波和反转恢复脉冲序列。将检查结果，尤其是皮髓质区分的丧失以及血管穿入肾实质的程度，与移植排斥反应的临床和组织学诊断结果进行了比较。对11例临床肾移植正常的患者进行的13次MR检查显示皮髓质区分正常。所有11例患者的肾血管均延伸至肾实质，38%延伸至皮质。对22例临床或组织学诊断为急性和/或慢性移植排斥反应的患者进行的37次MR检查中，8%的患者皮髓质区分正常，24%的患者皮髓质区分模糊，68%的患者皮髓质区分消失。32%的患者可见肾实质血管，但仅8%延伸至皮质水平。在68%的移植排斥反应检查中，未见实质血管。当皮髓质区分模糊或消失时，6%的患者血管形态正常；68%的病例无法识别实质血管。我们得出结论，皮髓质区分和肾血管形态是评估肾移植排斥反应的有用参数。
