期刊
ACADEMIC RADIOLOGY
卷 16, 期 9, 页码 1077-1085出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.acra.2009.03.020
关键词
Rejection; perfusion; functional MRI; transplant; allograft
资金
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [R01DK073680] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES [T32GM008692] Funding Source: NIH RePORTER
- NIDDK NIH HHS [R01 DK073680-03, R01 DK073680] Funding Source: Medline
- NIGMS NIH HHS [T32 GM008692] Funding Source: Medline
Rationale and Objectives. The purpose of this Study was to evaluate prospectively a gadolinium-based perfusion technique for intrarenal blood flow in transplanted kidneys and to determine if magnetic resonance imaging (MRI) measurements of intrarenal perfusion could be used to differentiate between normal-functioning kidney allografts and allografts with acute tubular necrosis (ATN) or acute rejection. Materials and Methods. Twenty-one subjects were enrolled within 4 months of receiving a kidney transplant. A biopsy was performed on subjects to diagnose each allograft as having either ATN or acute rejection. A group of subjects with normal functioning transplants was also enrolled in our study. MRI perfusion images were acquired on a 1.5 T MRI system within 48 hours after biopsy using an echo planar, T2*-weighted sequence, and an injection of gadodiamide contrast agent administered at a dose of 0.1 mmol/kg. Scan parameters were: repetition time/echo time/flip = 1000 ms/30 ms/60 degrees, field of view = 340 x 340 mm, matrix = 128 x 64, slice thickness = 10 mm, and temporal resolution = 1.0 seconds. Cortical and medullary blood flow values were calculated. Results. Medullary blood flow values were significantly (P = .02) lower in allografts undergoing acute rejection (121 +/- 41 rnL/100 g/min) compared to normal-functioning allografts (221 +/- 96 mL/100 g/min) and those with ATN (247 +/- 124 mL/100 g/min). Cortical blood flow values were also significantly (P = .03) reduced in allografts with acute rejection (243 +/- 116 mL/100 g/min) compared to those with normal function (413 +/- 116 mL/100 g/min). Conclusions. Preliminary results indicate that MRI perfusion techniques may provide a means of determining noninvasively the viability of renal allografts, potentially alleviating the need for biopsy in some patients.
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