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采用压缩感知对比增强磁共振估算常规腹部成像中的分肾功能:一项与动态肾功能闪烁显像比较的、针对肾功能保留参数恶化患者的可行性研究。

Estimation of differential renal function on routine abdominal imaging employing compressed-sensed contrast-enhanced MR: a feasibility study referenced against dynamic renal scintigraphy in patients with deteriorating renal retention parameters.

机构信息

Department of Radiology, University Hospital of Basel, 4031, Basel, Switzerland.

Department of Nuclear Medicine, University Hospital of Basel, Basel, Switzerland.

出版信息

Abdom Radiol (NY). 2023 Apr;48(4):1329-1339. doi: 10.1007/s00261-023-03823-2. Epub 2023 Feb 2.

Abstract

PURPOSE

To assess whether high temporal/spatial resolution GRASP MRI acquired during routine clinical imaging can identify several degrees of renal function impairment referenced against renal dynamic scintigraphy.

METHODS

This retrospective study consists of method development and method verification parts. During method development, patients subject to renal imaging using gadoterate meglumine and GRASP post-contrast MRI technique (TR/TE 3.3/1.6 ms; FoV320 × 320 mm; FA12°; Voxel1.1 × 1.1x2.5 mm) were matched into four equally-sized renal function groups (no-mild-moderate-severe impairment) according to their laboratory-determined estimated glomerular filtration rates (eGFR); 60|120 patients|kidneys were included. Regions-of-interest (ROIs) were placed on cortices, medullary pyramids and collecting systems of bilateral kidneys. Cortical perfusion, tubular concentration and collecting system excretion were determined as Time(sec), Slope (sec), and Time (sec), respectively, and were measured by a combination of extraction of time intensity curves and respective quantitative parameters. For method verification, patients subject to GRASP MRI and renal dynamic scintigraphy (99mTc-MAG3, 100 MBq/patient) were matched into three renal function groups (no-mild/moderate-severe impairment). Split renal function parameters post 1.5-2.5 min as well as MAG3 TER were correlated with time intensity parameters retrieved using GRASP technique; 15|30 patients|kidneys were included.

RESULTS

Method development showed differing values for Time(71|75|93|122 s), Slope(2.6|2.1|1.3|0.5 s) and Time(90|111|129|139 s) for the four renal function groups with partial significant tendencies (several p-values <  0.001). In method verification, 29/30 kidneys (96.7%) were assigned to the correct renal function group.

CONCLUSION

High temporal and spatial resolution GRASP MR imaging allows to identify several degrees of renal function impairment using routine clinical imaging with a high degree of accuracy.

摘要

目的

评估常规临床成像期间采集的高时间/空间分辨率 GRASP MRI 是否可以根据肾动态闪烁显像来识别几种程度的肾功能损害。

方法

本研究由方法开发和方法验证两部分组成。在方法开发过程中,根据实验室确定的估算肾小球滤过率(eGFR),将接受钆特酸葡甲胺肾成像和 GRASP 对比后 MRI 技术(TR/TE3.3/1.6ms;视野 320×320mm;FA12°;体素 1.1×1.1x2.5mm)的患者匹配到四个同样大小的肾功能组(无-轻度-中度-重度损害)中;共纳入 60|120 名患者|肾脏。在双侧肾脏的皮质、髓质锥体和集合系统上放置感兴趣区(ROI)。通过提取时间强度曲线和各自的定量参数的组合,确定皮质灌注、管状浓缩和收集系统排泄的时间(sec)、斜率(sec)和时间(sec)。对于方法验证,将接受 GRASP MRI 和肾动态闪烁显像(99mTc-MAG3,100MBq/患者)的患者匹配到三个肾功能组(无-轻度/中度-重度损害)中。将 1.5-2.5 分钟后的分肾功能参数和 MAG3 TER 与使用 GRASP 技术检索到的时间强度参数相关联;共纳入 15|30 名患者|肾脏。

结果

方法开发显示,四个肾功能组的时间(71|75|93|122s)、斜率(2.6|2.1|1.3|0.5s)和时间(90|111|129|139s)值不同,具有部分显著趋势(几个 p 值 <  0.001)。在方法验证中,30 个肾脏中的 29 个(96.7%)被正确分配到肾功能组。

结论

高时间和空间分辨率的 GRASP MRI 允许使用常规临床成像以高精度识别几种程度的肾功能损害。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd88/10115688/7ebe6a85cce6/261_2023_3823_Fig1_HTML.jpg

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