Blood oxygen level-dependent (BOLD) MRI analysis in atherosclerotic renal artery stenosis.
Blood oxygen level-dependent (BOLD) MRI analysis in atherosclerotic renal artery stenosis.
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DOI：
10.1097/mnh.0b013e32836400b2
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发表时间：
2013-09
影响因子：
3.2
通讯作者：
Textor SC
中科院分区：
文献类型：
--
作者：
Gloviczki ML;Saad A;Textor SC
血氧水平依赖磁共振成像（BOLD MRI）是一种评估肾组织氧合的无创技术，不需要造影剂暴露，有可能对动脉粥样硬化性肾动脉狭窄（ARAS）患者进行功能评估。在许多接受药物降压治疗数年而未恢复肾血流量的患者中，皮质-髓质氧合梯度保持正常。目前的回顾是特别感兴趣的，因为新的方法被应用于分析BOLD MRI打开其在临床实践中更广泛的应用前景。最近的研究结果表明，更严重的血管损伤最终压倒了这些适应性变化，导致明显的皮质缺氧和髓质缺氧区扩大。“分级肾缺氧”分析方法是作为BOLD MRI分析的一种替代方法而发展起来的，它避免了对皮质和髓质离散值的假设，并减少了与操作员选择roi相关的偏差。我们相信，BOLD MRI的应用和分析可以为不可逆肾损伤发生前的肾功能变化提供关键的见解，并可能确定最有可能从逆转或修复组织氧合障碍的措施中获益的患者。
Blood Oxygen Level Dependent Magnetic Resonance Imaging (BOLD MRI) is a noninvasive tehnique evaluating kidney tissue oxygenation that requires no contrast exposure with the potential to allow functional assessment for patients with Atherosclerotic Renal Artery Stenosis (ARAS). Normal cortical-to-medulla oxygenation gradients are preserved in many patients treated for several years with medical antihypertensive therapy without restoring renal blood flow. The current review is of particular interest as new methods were applied to the analyses of BOLD MRI opening perspective of its wider utilization in the clinical practice. Recent findings show that more severe vascular compromise ultimately overwhelms these adaptive changes, leading to overt cortical hypoxia and expansion of medullary hypoxic zones. “Fractional kidney hypoxia” method of analysis, developed as an alternative method of BOLD MRI analysis, avoids the assumption of discrete cortical and medullary values and decreases the bias related to operator selection of ROIs. We believe that thoughtful application and analysis of BOLD MRI can provide critical insights into changes in renal function prior to the onset of irreversible renal injury and may identify patients most likely to gain from measures to reverse or repair disorders of tissue oxygenation.