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多囊肾病的严重程度由多参数 MRI 揭示。

Severity of polycystic kidney disease revealed by multiparametric MRI.

机构信息

Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

出版信息

Magn Reson Med. 2023 Sep;90(3):1151-1165. doi: 10.1002/mrm.29679. Epub 2023 Apr 24.

Abstract

PURPOSE

We aimed to compare multiple MRI parameters, including relaxation rates ( , , and ), ADC from diffusion weighted imaging, pool size ratio (PSR) from quantitative magnetization transfer, and measures of exchange from spin-lock imaging ( ), for assessing and predicting the severity of polycystic kidney disease (PKD) over time.

METHODS

Pcy/Pcy mice with CD1 strain, a mouse model of autosomal dominant PKD, were imaged at 5, 9, and 26 wk of age using a 7T MRI system. Twelve-week normal CD1 mice were used as controls. Post-mortem paraffin tissue sections were stained using hematoxylin and eosin and picrosirius red to identify histological changes.

RESULTS

Histology detected segmental cyst formation in the early stage (week 5) and progression of PKD over time in Pcy kidneys. In -weighted images, small cysts appeared locally in cystic kidneys in week 5 and gradually extended to the whole cortex and outer stripe of outer medulla region from week 5 to week 26. Regional PSR, , , and decreased consistently over time compared to normal kidneys, with significant changes detected in week 5. Among all the MRI measures, and allow highest detectability to PKD, while PSR and have highest correlation with pathological indices of PKD. Using optimum MRI parameters as regressors, multiple linear regression provides reliable prediction of PKD progression.

CONCLUSION

, , and PSR are sensitive indicators of the presence of PKD. Multiparametric MRI allows a comprehensive analysis of renal changes caused by cyst formation and expansion.

摘要

目的

我们旨在比较多种 MRI 参数,包括弛豫率( , , 和 )、来自弥散加权成像的 ADC、来自定量磁化传递的池大小比(PSR),以及来自自旋锁定成像的交换测量值( ),以评估和预测多囊肾病(PKD)随时间的严重程度。

方法

使用 7T MRI 系统对具有 CD1 品系的常染色体显性多囊肾病(PKD)小鼠模型 Pcy/Pcy 进行 5、9 和 26 周龄的成像。12 周龄的正常 CD1 小鼠用作对照。使用苏木精和伊红以及苦味酸天狼星红染色对死后石蜡组织切片进行组织学评估。

结果

组织学检测到 Pcy 肾脏在第 5 周出现节段性囊肿形成,且 PKD 随时间推移而进展。在 T2 加权图像中,第 5 周时囊性肾脏中局部出现小囊肿,并逐渐从第 5 周到第 26 周扩展到整个皮质和外髓外带区域。与正常肾脏相比,区域 PSR、 、 、 随时间推移持续下降,第 5 周时变化显著。在所有 MRI 测量值中, 和 对 PKD 的检测能力最高,而 PSR 和 与 PKD 的病理指标相关性最高。使用最佳 MRI 参数作为回归量,多元线性回归可对 PKD 进展进行可靠预测。

结论

、 和 PSR 是 PKD 存在的敏感指标。多参数 MRI 允许对囊肿形成和扩张引起的肾脏变化进行全面分析。

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