Consistency of Multiple Renal Functional MRI Measurements Over 18 Months
Consistency of Multiple Renal Functional MRI Measurements Over 18 Months
复制标题
DOI：
10.1002/jmri.26001
复制
发表时间：
2018-08-01
影响因子：
4.4
通讯作者：
Prasad, Pottumarthi
中科院分区：
文献类型：
--
作者：
Li, Lu-Ping;Thacker, Jon;Prasad, Pottumarthi
研究背景：目前迫切需要对进展性慢性肾脏病（CKD）患者和可能对候选治疗有反应的患者进行鉴别。功能性磁共振成像测量显示出了希望。然而，关于测量的一致性的知识对于进行纵向研究是必不可少的。目的/假设为了调查健康受试者中重复功能MRI测量的一致性。研究类型前瞻性纵向研究。受试者17名健康受试者在两个不同的场合进行了检查，间隔18个月。场强/序列多梯度回忆回波，在3 T扫描仪上使用2D导航门控血流敏感交替反转恢复True-FISP和自旋回波平面扩散加权序列。使用自定义图像处理工具箱分析血氧水平依赖（BOLD）R2*、动脉自旋标记（ASL）灌注衍生血流（BF）和表观扩散系数（ADC）图。将感兴趣区域（ROI）置于肾皮质、髓质和整个肾脏上。多名研究者参与了ROI的定义，统计学检验使用受试者内和受试者间变异系数（CV）和Bland-Altman图来衡量测量的一致性和评估测量的偏倚。A非参数Wilcoxon检验被用来比较两个时间点之间的差异。ResultsThe intrasobject CV为R2* 和ADC分别为6.8%和5.3%，小（-3.8和5.3%）的偏差，分别比较基线和18个月的数据。肾皮质BF的受试者内CV（18.7%）高于R2* 和ADC，但在较短持续时间内与既往文献值相当。它还表现出较大的偏差（-15.4%）之间的两个时间点和显着较低的值（P=0.022）在18个月的data.Data ConclusionAll三个MRI参数超过18个月，即使扫描仪升级，并涉及多个观察员，表现出良好的一致性。这些结果有助于解释纵向数据，并支持使用这些方法来监测CKD患者的进展。证据等级：1技术有效性：第1阶段J. MAGN. RESON。《影像学》2018;48：514-521。
BackgroundIdentification of patients with progressive chronic kidney disease (CKD) and those likely to respond to candidate therapeutics is urgently needed. Functional MRI measurements have shown promise. However, knowledge about the consistency of the measurements is essential to conduct longitudinal studies.Purpose/HypothesisTo investigate the consistency of repeated functional MRI measurements in healthy subjects.Study TypeProspective, longitudinal study.SubjectsSeventeen healthy subjects were examined on two different occasions, 18 months apart.Field Strength/SequenceMultiple gradient-recalled-echo, 2D navigator-gated flow-sensitive alternating inversion recovery True-FISP and spin-echo planar diffusion-weighted sequences were used on a 3T scanner. Images were acquired on two different scanner configurations.AssessmentBlood oxygenation level-dependent (BOLD) R2*, arterial spin labeling (ASL) perfusion-derived blood flow (BF) and apparent diffusion coefficient (ADC) maps were analyzed using a custom image processing toolbox. Regions of interest (ROIs) were placed on renal cortex, medulla, and whole kidney. Multiple researchers were involved in defining the ROIs.Statistical TestsIntra- and intersubject coefficients of variation (CV) and Bland-Altman plots were used to measure consistency and evaluate bias in the measurements. A nonparametric Wilcoxon test was used to compare differences between two timepoints.ResultsThe intrasubject CV for R2* and ADC were 6.8% and 5.3% with small (-3.8 and 5.3%) bias, respectively, comparing baseline and 18-month data. Intrasubject CV for renal cortex BF was higher (18.7%) compared to R2* and ADC, but comparable to prior literature values over shorter durations. It also exhibited a larger bias (-15.4%) between two timepoints and significantly lower values (P=0.022) at 18-month data.Data ConclusionAll three MRI parameters over 18 months, even with a scanner upgrade and involving multiple observers, showed good consistency. These results are useful for the interpretation of longitudinal data and support the use of these methods to monitor progression in patients with CKD. Level of Evidence: 1 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2018;48:514-521.