Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
Institute of Medical Microbiology, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
J Magn Reson Imaging. 2023 Dec;58(6):1954-1963. doi: 10.1002/jmri.28698. Epub 2023 Apr 7.
Preventing sepsis-associated acute kidney injury (S-AKI) can be challenging because it develops rapidly and is often asymptomatic. Probability assessment of disease progression for therapeutic follow-up and outcome are important to intervene and prevent further damage.
To establish a noninvasive multiparametric MRI (mpMRI) tool, including T , T , and perfusion mapping, for probability assessment of the outcome of S-AKI.
Preclinical randomized prospective study.
One hundred and forty adult female SD rats (65 control and 75 sepsis).
FIELD STRENGTH/SEQUENCE: 9.4T; T and perfusion map (FAIR-EPI) and T map (multiecho RARE).
Experiment 1: To identify renal injury in relation to sepsis severity, serum creatinine levels were determined (31 control and 35 sepsis). Experiment 2: Animals underwent mpMRI (T , T , perfusion) 18 hours postsepsis. A subgroup of animals was immediately sacrificed for histology examination (nine control and seven sepsis). Result of mpMRI in follow-up subgroup (25 control and 33 sepsis) was used to predict survival outcomes at 96 hours.
Mann-Whitney U test, Spearman/Pearson correlation (r), P < 0.05 was considered statistically significant.
Severely ill septic animals exhibited significantly increased serum creatinine levels compared to controls (70 ± 30 vs. 34 ± 9 μmol/L, P < 0.0001). Cortical perfusion (480 ± 80 vs. 330 ± 140 mL/100 g tissue/min, P < 0.005), and cortical and medullary T relaxation time constants were significantly reduced compared to controls (41 ± 4 vs. 37 ± 5 msec in cortex, P < 0.05, 52 ± 7 vs. 45 ± 6 msec in medulla, P < 0.05). The combination of cortical T relaxation time constants and perfusion results at 18 hours could predict survival outcomes at 96 hours with high sensitivity (80%) and specificity (73%) (area under curve of ROC = 0.8, J = 0.52).
This preclinical study suggests combined T relaxation time and perfusion mapping as first line diagnostic tool for treatment planning.
2 TECHNICAL EFFICACY STAGE: 2.
预防脓毒症相关性急性肾损伤（S-AKI）具有挑战性，因为它发展迅速且通常无症状。为了进行治疗随访和预测结果，疾病进展的概率评估对于干预和预防进一步的损伤很重要。
建立一种非侵入性多参数 MRI（mpMRI）工具，包括 T1 、 T2 和灌注图，用于预测 S-AKI 结局的概率。
临床前随机前瞻性研究。
140 只成年雌性 SD 大鼠（65 只对照和 75 只脓毒症）。
磁场强度/序列：9.4T；T1 和灌注图（FAIR-EPI）和 T2 图（多回波 RARE）。
实验 1：为了确定与脓毒症严重程度相关的肾损伤，测定了血清肌酐水平（31 只对照和 35 只脓毒症）。实验 2：动物在脓毒症后 18 小时进行 mpMRI（T1 、 T2 、灌注）。亚组动物立即进行组织学检查（9 只对照和 7 只脓毒症）。随访亚组的 mpMRI 结果（25 只对照和 33 只脓毒症）用于预测 96 小时的生存结果。
Mann-Whitney U 检验，Spearman/Pearson 相关系数（r），P<0.05 被认为具有统计学意义。
与对照组相比，病重的脓毒症动物的血清肌酐水平显著升高（70±30 与 34±9μmol/L，P<0.0001）。皮质灌注（480±80 与 330±140mL/100g 组织/分钟，P<0.05）和皮质和髓质 T2 弛豫时间常数均显著降低（皮质 41±4 与 37±5msec，P<0.05，髓质 52±7 与 45±6msec，P<0.05）。18 小时的皮质 T2 弛豫时间常数和灌注联合结果可预测 96 小时的生存结果，具有高灵敏度（80%）和特异性（73%）（ROC 曲线下面积为 0.8，J=0.52）。
这项临床前研究表明，联合 T2 弛豫时间和灌注图作为治疗计划的一线诊断工具。
2 技术功效分期：2。
