MAGNETIC-RESONANCE-IMAGING OF CARDIAC TRANSPLANTS - THE EVALUATION OF REJECTION OF CARDIAC ALLOGRAFTS WITH AND WITHOUT IMMUNOSUPPRESSION
MAGNETIC-RESONANCE-IMAGING OF CARDIAC TRANSPLANTS - THE EVALUATION OF REJECTION OF CARDIAC ALLOGRAFTS WITH AND WITHOUT IMMUNOSUPPRESSION
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DOI：
10.1161/01.cir.74.1.145
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发表时间：
1986-07-01
期刊：
影响因子：
37.8
通讯作者：
HIGGINS, CB
中科院分区：
文献类型：
--
作者：
AHERNE, T;TSCHOLAKOFF, D;HIGGINS, CB
本研究的目的是评价磁共振成像（MRI）在体内表征心脏移植术后急性心肌排斥反应相关组织变化的潜力。在15只接受异位心脏移植的犬中，6只作为未治疗对照，9只接受免疫抑制治疗（25 mg/kg/天环孢素，1 mg/kg/天泼尼松）。在移植后2至3、7至10、14至17和26至29天以及动物处死后立即对每只犬进行系列心电图门控MRI（自旋回波技术）和同种异体移植物活检样本的组织学检查。未处理的同种异体移植物显示出T2（自旋-自旋）弛豫时间的显著增加（p <0.01）（T2 = 66 ± 0.01）。8毫秒）和强度值与天然心脏中的值（T2 = 44 . ±. 6毫秒），早在移植后1周。T2值的显著差异可以在体内以及尸检中观察到，并且对应于排斥过程的组织学进展。环孢素治疗的同种异体移植物和自体心脏的T1，T2或强度值无显著差异，但两只狗的T2弛豫时间和信号强度在移植心脏中同时增加，并伴有排斥反应的组织学证据，表明免疫抑制治疗失败。排斥反应严重程度的组织学分级与心脏移植物的T2弛豫时间之间存在显着相关性（r = 0.72）。同样，当比较自体心脏和同种异体心脏之间的差异时，体内T2值和含水量百分比之间存在显著的线性关系（r = 0.92，p <0.001）。因此，心电门控MRI在体内是一种敏感的，非侵入性的方式来检测和估计心脏移植急性排斥反应的严重程度。通过定量T2弛豫时间可以进行心肌组织表征。
The purpose of this study was to evaluate the potential of magnetic resonance imaging (MRI) in vivo for the characterization of tissue changes associated with acute myocardial rejection after cardiac transplatantion. Of 15 dogs that underwent heterotopic cardiac transplantation, six served as untreated controls, and nine received immunosuppressive therapy (25 mg/kg/day cyclosporine, 1 mg/kg/day prednisone). Serial electrocardiographically gated MRI (spin-echo technique) and histologic examinations of allograft biopsy samples were performed for each dog at 2 to 3, 7 to 10, 14 to 17, and 26 to 29 days after transplatantion and immediately after animals were killed. Untreated allografts showed a significant increase (p < .01) in T2 (spin-spin) relaxation time (T2 = 66 .+-. 8 msec) and intensity values compared with values in the native hearts (T2 = 44 .+-. 6 msec) as early as 1 week after transplantation. The significant difference in T2 values could be observed in vivo as well as on postmortem examination and corresponded to histologic progression of the rejection process. There was no significant difference in T1, T2, or intensity values in cyclosporine-treated allografts and native hearts except in two dogs in which T2 relaxation times and signal intensity in the transplanted hearts increased simultaneously with histologic evidence of rejection, indicating failure of immunosuppressive therapy. There was a significant correlation between histologic grading of severity of rejection and T2 relaxation times of the cardiac tranpslants (r = .72). Likewise, there was a significant linear relationship between T2 values in vivo and percent water content when the differences between native hearts and allografts were compared (r = .92, p < .001). Thus, electrocardiographically gated MRI in vivo is a sensitive, noninvasive modality for detecting and estimating severity of acute rejection of cardiac transplants. Myocardial tissue characterization is possible by quantitating T2 relaxation times.