Zhao Long, Xu Feng-Bo, Liu Jia-Yi, Li Shuang, Zhang Nan, Sun Zhong-Hua, Wang Guo-Qin, Xu Lei
Department of Radiology, Beijing Anzhen Hospital, Beijing, China.
Department of Nephrology, Beijing Anzhen Hospital, Beijing, China.
Ren Fail. 2025 Dec;47(1):2444403. doi: 10.1080/0886022X.2024.2444403. Epub 2025 Jan 6.
To evaluate the function of kidneys with renal artery stenosis using multiparametric magnetic resonance imaging, assess the diagnostic efficacy of multiparametric magnetic resonance imaging for single kidney dysfunction.
Renal multiparametric magnetic resonance imaging was performed on 62 patients with RAS using the Philips Ingenia CX 3.0 T MRI machine. The scanning sequences included arterial spin labeling, phase contrast MRI, diffusion weighted imaging, T1 mapping, and blood oxygen level-dependent MRI. All patients underwent radionuclide renal dynamic imaging, and the glomerular filtration rate (GFR) was calculated to determine renal function. Individual kidneys from renal artery stenosis patients were classified into normal (GFR ≥ 30) and reduced (GFR < 30) groups and the ability of the uni- and multi-variate logistic regression model to predict the group was determined.
MR parameters demonstrated considerable diagnostic efficacy for single kidney dysfunction, with AUC range of 0.597- 0.864. The strongest predictor was mean renal artery blood flow. The sensitivity and specificity were 0.93 and 0.69AUC was 0.864. The strongest predictors of the renal microstructure were cortical apparent diffusion coeffecient and T1 value, with ROC AUCs of 0.756 and 0.741, sensitivities of 0.875 and 0.689, and specificities of 0.537 and 0.731. Multiparametric MRI combined with the values of cortical renal blood flow and cortical T1 exhibited the highest diagnostic efficacy, with an AUC of 0.92, and sensitivity of 0.919, and specificity of 0.743.
Multiparametric magnetic resonance imaging can effectively detect the single renal dysfunction of kidneys with renal artery stenosis, which holds promise for the diagnosis and prognosis of patients with renal artery stenosis.
利用多参数磁共振成像评估肾动脉狭窄患者肾脏的功能，评估多参数磁共振成像对单肾肾功能不全的诊断效能。
使用飞利浦Ingenia CX 3.0 T MRI机器对62例肾动脉狭窄患者进行肾脏多参数磁共振成像检查。扫描序列包括动脉自旋标记、相位对比磁共振成像、扩散加权成像、T1 mapping和血氧水平依赖性功能磁共振成像。所有患者均接受放射性核素肾动态显像，并计算肾小球滤过率（GFR）以确定肾功能。将肾动脉狭窄患者的单个肾脏分为正常（GFR≥30）组和降低（GFR<30）组，并确定单变量和多变量逻辑回归模型预测该组的能力。
磁共振参数对单肾肾功能不全显示出相当高的诊断效能，AUC范围为0.597 - 0.864。最强的预测指标是平均肾动脉血流量。敏感性和特异性分别为0.93和0.69，AUC为0.864。肾脏微观结构的最强预测指标是皮质表观扩散系数和T1值，ROC AUC分别为0.756和0.741，敏感性分别为0.875和0.689，特异性分别为0.537和0.731。多参数磁共振成像结合皮质肾血流量和皮质T1值显示出最高的诊断效能，AUC为0.92，敏感性为0.919，特异性为0.743。
多参数磁共振成像能够有效检测肾动脉狭窄患者的单肾肾功能不全，这为肾动脉狭窄患者的诊断和预后评估提供了希望。
