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正常肾动脉血流的测量:电影相位对比磁共振成像与对氨基马尿酸清除率的比较

Measurement of normal renal artery blood flow: cine phase-contrast MR imaging vs clearance of p-aminohippurate.

作者信息

Wolf R L, King B F, Torres V E, Wilson D M, Ehman R L

机构信息

Department of Diagnostic Radiology, Mayo Clinic and Foundation, Rochester, MN 55905.

出版信息

AJR Am J Roentgenol. 1993 Nov;161(5):995-1002. doi: 10.2214/ajr.161.5.8273644.

Abstract

OBJECTIVE

The purpose of this study was to compare cine phase-contrast MR imaging with renal clearance of p-aminohippurate for measuring normal renal blood flow. A reliable technique for evaluation of renal hemodynamics would be useful for studying renal vascular diseases and the effects of treatment. Measurements of renal blood flow based on renal clearance of p-aminohippurate are limited in that the kidneys are not studied separately, temporal resolution is poor, and normal renal function is required.

SUBJECTS AND METHODS

Bilateral oblique sagittal cine phase-contrast MR images were obtained simultaneously in 10 healthy adult volunteers, with the imaging planes oriented perpendicular to the left and right renal arteries in order to measure through-plane flow. Velocity encoding was 150 cm/sec (seven of 10 volunteers) and 100 cm/sec (eight of 10 volunteers). Axial cine phase-contrast images of the abdominal aorta above and below the origins of the renal arteries were obtained in six volunteers. In these cases, renal blood flow was determined by measuring the difference between suprarenal and infrarenal aortic flow. For all volunteers, renal clearance of p-aminohippurate was determined immediately after MR measurements.

RESULTS

Renal blood flow measurements determined by using cine phase-contrast MR imaging were in close agreement with those determined by using clearance of p-aminohippurate. At a velocity encoding of 150 cm/sec, the mean difference was 69 ml/min (95% confidence interval, -31 to 169 ml/min). At a velocity encoding of 100 cm/sec, the mean difference was 39 ml/min (95% confidence interval, -100 to 177 ml/min). Aortic flow measurements using cine phase-contrast MR imaging appeared to be less reliable for determining renal blood flow than measurements in the individual renal arteries, with a mean difference of -75 ml/min (95% confidence interval, -381 to 231 ml/min) compared with renal blood flow determined by using clearance of p-aminohippurate.

CONCLUSION

We conclude that cine phase-contrast MR imaging is a promising technique for noninvasive measurement of renal blood flow. Measurements agreed closely with those obtained by using clearance of p-aminohippurate. In addition, the MR technique is faster, can be used to measure unilateral or bilateral renal blood flow, and does not depend on renal function.

摘要

目的

本研究旨在比较电影相位对比磁共振成像与对氨基马尿酸肾清除率在测量正常肾血流量方面的差异。一种可靠的评估肾血流动力学的技术对于研究肾血管疾病及治疗效果将很有用。基于对氨基马尿酸肾清除率来测量肾血流量存在局限性,即无法分别对双肾进行研究,时间分辨率较差,且需要正常的肾功能。

受试者与方法

对10名健康成年志愿者同时获取双侧斜矢状位电影相位对比磁共振图像,成像平面垂直于左右肾动脉以测量平面内血流。速度编码为150 cm/秒(10名志愿者中的7名)和100 cm/秒(10名志愿者中的8名)。对6名志愿者获取肾动脉起始部上方和下方腹主动脉的轴位电影相位对比图像。在这些病例中,通过测量肾上腺上方和下方主动脉血流的差异来确定肾血流量。对所有志愿者,在磁共振测量后立即测定对氨基马尿酸肾清除率。

结果

使用电影相位对比磁共振成像测定的肾血流量与使用对氨基马尿酸清除率测定的结果密切相关。速度编码为150 cm/秒时,平均差异为69 ml/分钟(95%置信区间,-31至169 ml/分钟)。速度编码为100 cm/秒时,平均差异为39 ml/分钟(95%置信区间,-100至177 ml/分钟)。与使用对氨基马尿酸清除率测定的肾血流量相比,利用电影相位对比磁共振成像测量主动脉血流来确定肾血流量似乎可靠性较低,平均差异为-75 ml/分钟(95%置信区间,-381至231 ml/分钟)。

结论

我们得出结论,电影相位对比磁共振成像是一种很有前景的无创测量肾血流量的技术。测量结果与使用对氨基马尿酸清除率获得的结果密切一致。此外,磁共振技术速度更快,可用于测量单侧或双侧肾血流量,且不依赖肾功能。

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