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[利用钆喷酸葡胺动态磁共振成像评估肾功能]

[Evaluation of renal function using Gd-DTPA dynamic MR imaging].

作者信息

Furukawa A, Murata K, Morita R

机构信息

Department of Radiology, Shiga University of Medical Science, Japan.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1996 Apr;56(5):264-74.

PMID:8692650
Abstract

To establish a new method for evaluating renal function using MRI, we performed dynamic Gd-DTPA enhanced MR imaging at 1.5 T in 68 subjects (71 examinations), including 23 normal volunteers, 19 patients with chronic renal failure, 22 with hydronephrosis, and 7 with renal vascular disorders. Thirty GRASS images [35/9/20 degrees /1 (TR/TE/Flip Angle/NEX)] were obtained after a bolus injection of Gd-DTPA (0.2 mmol/Kg) in each case, and were evaluated in the following respects. (1) Whether or not the initial signal increase and/or the following signal drop in cortex was observed. (2) Whether or not the signal drop in medulla and/or calyces was observed. (3) Time between initial signal increase in cortex and signal drop in medulla (Ta). (4) Time between signal drop in medulla and calyces (Tb). (5) Time between signal increase in cortex and signal drop in calyces (Tc). (6) Maximum ratio of signal intensity between cortex and medulla (Max. C/M). In normal subjects, the initial signal increase and the following signal drop in cortex, and the signal drop in medulla and calyces were observed. In patients with abnormal renal function, the characteristic signal changes described above were not seen clearly or disappeared in many cases. In normal subjects, Ta, Tb, Tc, and Max. C/M were 41.9 +/- 6.9 sec, 53.2 +/- 10.6 sec, 95.0 +/- 9.5 sec, and 1.10 +/- 0.05, respectively. In the patients, time parameters were significantly larger than those of normal subjects and C/M ratios were lower. This study suggested that dynamic Gd-DTPA renal MR imaging can serve as a new method for the evaluation of renal function.

摘要

为建立一种利用磁共振成像(MRI)评估肾功能的新方法,我们对68名受试者(共进行了71次检查)进行了1.5T的动态钆喷酸葡胺(Gd-DTPA)增强磁共振成像,其中包括23名正常志愿者、19名慢性肾衰竭患者、22名肾积水患者和7名肾血管疾病患者。在每种情况下,静脉注射Gd-DTPA(0.2 mmol/Kg)后获取30幅梯度回波(GRASS)图像[35/9/20度/1(TR/TE/翻转角/激励次数)],并从以下几个方面进行评估。(1)观察皮质是否出现初始信号增强和/或随后的信号下降。(2)观察髓质和/或肾盏是否出现信号下降。(3)皮质初始信号增强与髓质信号下降之间的时间(Ta)。(4)髓质与肾盏信号下降之间的时间(Tb)。(5)皮质信号增强与肾盏信号下降之间的时间(Tc)。(6)皮质与髓质信号强度的最大比值(最大C/M)。在正常受试者中,观察到皮质的初始信号增强和随后的信号下降,以及髓质和肾盏的信号下降。在肾功能异常的患者中,上述特征性信号变化在许多情况下未清晰出现或消失。在正常受试者中,Ta、Tb、Tc和最大C/M分别为41.9±±6.9秒、53.2±±10.6秒、95.0±±9.5秒和1.10±±0.05。在患者中,时间参数明显大于正常受试者,且C/M比值较低。本研究表明,动态Gd-DTPA肾脏磁共振成像可作为评估肾功能的一种新方法。

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