Strich G, Gerber K, Slutsky R A
Magn Reson Imaging. 1985;3(1):37-42. doi: 10.1016/0730-725x(85)90007-4.
In order to assess the sensitivity of nuclear magnetic resonance (NMR) in detecting acute renal vascular insufficiency, in vitro NMR spectroscopy (at 0.25 T) was performed on rabbit renal cortices following 45 min of unilateral renal artery (RAO) or renal vein occlusion (RVO). Data were obtained both with and without paramagnetic enhancement with gadolinium-DTPA (Gd-DTPA). In the absence of contrast material, RVO was distinguished by markedly elevated spin-lattice (T1) and spin-spin (T2) relaxation times when compared to the contralateral control kidney [mean increase of 29% in T1 (p less than 0.001) and 19% in T2 (p less than .001)]. RAO produced no change in T1 (p = N.S.) and a small change in T2 (mean increase of 11%, p less than .01). Five min following injection of 0.05 mM/kg of Gd-DTPA, relaxation times of control kidneys were markedly shortened [mean decrease 75% in T1 (p less than .001) and 12% in T2 (p less than 0.01)]. With Gd-DTPA, kidneys with RVO continued to have elevated T1 and T2 relaxation time, and kidneys with RAO maintained their essentially normal pre-contrast relaxation time values. We conclude that non-contrast NMR tissue analysis clearly differentiated normal from congested (RVO) kidneys, but not from acutely ischemic (RAO) kidneys. Paramagnetic enhancement with Gd-DTPA allows the differentiation of normally perfused from acutely ischemic or congested kidneys.
为了评估核磁共振（NMR）检测急性肾血管功能不全的敏感性，在单侧肾动脉闭塞（RAO）或肾静脉闭塞（RVO）45分钟后，对兔肾皮质进行了体外核磁共振波谱分析（0.25T）。在使用和不使用钆喷酸葡胺（Gd-DTPA）进行顺磁增强的情况下均获取了数据。在没有造影剂的情况下，与对侧对照肾相比，RVO的特征是自旋晶格（T1）和自旋-自旋（T2）弛豫时间显著升高[T1平均增加29%（p<0.001），T2平均增加19%（p<0.001）]。RAO使T1无变化（p=无统计学意义），T2有小的变化（平均增加11%，p<0.01）。注射0.05 mM/kg的Gd-DTPA后5分钟，对照肾的弛豫时间显著缩短[T1平均减少75%（p<0.001），T2平均减少12%（p<0.01）]。使用Gd-DTPA时，RVO的肾T1和T2弛豫时间持续升高，而RAO的肾保持其造影前基本正常的弛豫时间值。我们得出结论，非造影NMR组织分析可明确区分正常肾与充血性（RVO）肾，但不能区分与急性缺血性（RAO）肾。Gd-DTPA顺磁增强可区分正常灌注肾与急性缺血或充血性肾。
