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T1 mapping 磁共振成像对慢性乙型肝炎病毒患者肾实质亚临床改变的无创评估。

Non-invasive Assessment of Subclinical Renal Parenchymal Changes in Chronic Hepatitis B Virus By T1 Mapping Magnetic Resonance Imaging.

机构信息

Department of Radiology, Göztepe Training and Research Hospital, İstanbul Medeniyet University, İstanbul, Turkey.

Department of Nephrology, Göztepe Training and Research Hospital, İstanbul Medeniyet University, İstanbul, Turkey.

出版信息

Balkan Med J. 2022 Mar 14;39(2):115-120. doi: 10.4274/balkanmedj.galenos.2021.2021-6-133.

Abstract

BACKGROUND

Renal parenchymal changes are seen in chronic hepatitis B virus (HBV) infection, and its disease diagnosis should be confirmed by renal biopsy, which is an invasive technique. Apparent-T1 mapping magnetic resonance imaging (MRI) is an established imaging technique that assesses subclinical tissue injury without using a contrast agent.

AIMS

To investigate the early stage subclinical renal changes without apparent renal dysfunction in patients with chronic HBV infection by renal apparent-T1 mapping MRI.

STUDY DESIGN

A cross-sectional study.

METHODS

This study included 45 participants with normal kidney function, wherein 25 have biopsy-proven chronic HBV hepatitis and 20 are healthy individuals. Liver and kidney biochemical tests were performed within 1 month before the MRI scan, and the estimated glomerular filtration rate was calculated by diet modification in renal disease formula. Breath-hold, electrocardiogram-gated Modified Look-Locker Imaging sequence was acquired in the coronal plane without contrast agent administration. Apparent-T1 mapping value was measured by manually drawing a region of interest in six points for both kidneys by two observers. Apparent-T1 mapping values were compared between the two groups.

RESULTS

The mean apparent-T1 mapping values of the kidneys were significantly higher in patients with chronic HBV infection compared to the control group (1445 ± 129 ms vs. 1306 ± 115 ms, = 0.003). Inter-class correlation coefficient measurement analysis showed excellent agreement.

CONCLUSION

Renal apparent-T1 mapping MRI may help show the early stage of renal parenchymal disease without apparent renal dysfunction in chronic HBV infection.

摘要

背景

慢性乙型肝炎病毒(HBV)感染可导致肾实质改变,其疾病诊断应通过肾活检确定,但这是一种有创技术。表观 T1 映射磁共振成像(MRI)是一种成熟的成像技术,可在不使用造影剂的情况下评估亚临床组织损伤。

目的

通过肾表观 T1 映射 MRI 研究慢性 HBV 感染患者早期亚临床无症状肾功能障碍的肾脏变化。

研究设计

横断面研究。

方法

本研究纳入了 45 名肾功能正常的参与者,其中 25 名患有经活检证实的慢性乙型肝炎,20 名是健康个体。在 MRI 扫描前 1 个月内进行肝肾功能生化检查,并通过肾脏病饮食改良公式计算估算肾小球滤过率。在不使用造影剂的情况下,进行冠状位屏息、心电图门控 Modified Look-Locker 成像序列采集。由两位观察者手动在六个点勾画双侧肾脏的感兴趣区来测量表观 T1 映射值。比较两组间的表观 T1 映射值。

结果

与对照组相比,慢性 HBV 感染患者的肾脏表观 T1 映射值明显更高(1445±129 ms 比 1306±115 ms,P=0.003)。组内相关系数测量分析显示具有极好的一致性。

结论

肾表观 T1 映射 MRI 可能有助于显示慢性 HBV 感染早期无明显肾功能障碍的肾实质疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc6e/8941224/1d84b176361c/BMJ-39-115-g1.jpg

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