BOLD-MRI for the assessment of renal oxygenation in humans: Acute effect of nephrotoxic xenobiotics
BOLD-MRI for the assessment of renal oxygenation in humans: Acute effect of nephrotoxic xenobiotics
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DOI：
10.1038/sj.ki.5000418
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发表时间：
2006-07-01
影响因子：
19.6
通讯作者：
Vogt, B.
中科院分区：
文献类型：
--
作者：
Hofmann, L.;Simon-Zoula, S.;Vogt, B.
肾髓质缺氧是药物性肾功能衰竭发生的关键因素。众所周知，药物会影响肾血流动力学，进而影响肾组织的氧合。使用血液氧合水平依赖的磁共振成像(BOLD-MRI)可以无创地评估人类肾脏氧合的变化。这项研究旨在利用BOLD-MRI测试特定药物对健康人肾氧合的急性影响。本文研究了非甾体抗炎药消炎痛、碘化放射造影剂(RCM)碘丙胺、钙调神经磷酸酶抑制剂环孢素微乳(CsA-ME)和曲罗莫司对30名健康志愿者肾组织氧合的急性影响。采用一种改进的多回波数据图像组合序列，获得12幅T2加权图像。选择4个冠状切片覆盖双侧肾脏。延髓和皮质的R-2*(1/T-2*)平均值在给予消炎痛和他克莫司后无明显变化。CsA-ME摄入后2 h，延髓(P=0.008)和皮质(P=0.004)的R-2*值均降低。在注射后20分钟内，碘丙咪胺引起延髓R-2*显著增加(P<；0.001)，而肾皮质则无相关变化。没有一项测量显示左肾和右肾存在差异。肾髓质氧分压在男女受试者之间差异有统计学意义(P=0.013)。BOLD-MRI是显示特定药物对健康肾组织影响的有效方法。单次给药后2小时，环孢素可增加肾髓质氧分压，而消炎痛和他克莫司对肾髓质氧分压无影响。注射碘RCM可降低肾髓质氧分压。
Hypoxia of renal medulla is a key factor implicated in the development of drug-induced renal failure. Drugs are known to influence renal hemodynamics and, subsequently, affect renal tissue oxygenation. Changes in renal oxygenation can be assessed non-invasively in humans using blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI). This study was designed to test the acute effects of administration of specific drugs in healthy human kidney oxygenation using BOLD-MRI. Acute changes in renal tissue oxygenation induced by the non-steroidal anti-inflammatory drug indomethacin, the iodinated radio-contrast media (RCM) iopromidum, and the calcineurin inhibitors cyclosporine micro-emulsion (CsA-ME) and tracrolimus were studied in 30 healthy volunteers. A modified Multi Echo Data Image Combination sequence was used to acquire 12 T-2*-weighted images. Four coronal slices were selected to cover both kidneys. The mean R-2* (1/T-2*) values determined in medulla and cortex showed no significant changes induced by indomethacin and tacrolimus administration. CsA-ME decreased medullary (P = 0.008) and cortical (P = 0.004) R-2* values 2 h after ingestion. Iopromidum caused a significant increase in medullary R-2* within the first 20 min after injection (P < 0.001), whereas no relevant changes were observed in renal cortex. None of the measurements showed left-right kidney differences. Significant differences in renal medullary oxygenation were evidenced between female and male subjects (P = 0.013). BOLD-MRI was efficient to show effects of specific drugs in healthy renal tissue. Cyclosporine increased renal medullary oxygenation 2 h after ingestion of a single dose, whereas indomethacin and tacrolimus showed no effect on renal oxygenation. Injection of iodinated RCM decreased renal medullary oxygenation.