Medullary Blood Oxygen Level-Dependent MRI Index (R2*) is Associated with Annual Loss of Kidney Function in Moderate CKD.
Medullary Blood Oxygen Level-Dependent MRI Index (R2*) is Associated with Annual Loss of Kidney Function in Moderate CKD.
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髓质血氧水平依赖磁共振成像指数（R2*）与中度慢性肾脏病患者肾功能的年度丧失相关。
DOI：
10.1159/000512854
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发表时间：
2020
影响因子：
4.2
通讯作者：
Prasad PV
中科院分区：
文献类型：
--
作者：
Li LP;Thacker JM;Li W;Hack B;Wang C;Kohn O;Sprague SM;Prasad PV
估计的肾小球滤过率（eGFR）经常用于监测肾脏疾病的进展。必须获得多个值，有时需要数年时间才能确定肾功能下降的速度。最近的数据表明，功能性MRI（fMRI）方法可能能够预测eGFR的损失。在之前的一项研究中，报告了糖尿病和中度慢性肾病（CKD）患者的多参数MRI基线数据。本报告扩展了我们先前的观察，以评估36个月内fMRI测量的时间变异性及其与eGFR年度变化的相关性。24例中度CKD受试者在36个月内完成了3组MRI扫描。使用3 T扫描仪获取血氧水平依赖性（BOLD）、动脉自旋标记灌注和扩散MRI图像。变异系数用于评价每个时间点受试者之间的变异性和每个受试者内的时间变异性。我们使用时间和MRI变量作为固定效应，基线截距作为随机效应，进行了混合效应模型，以检查GFR随时间的轨迹变化。评估了MRI图像标记物与eGFR年变化的相关性。与健康个体相比，中度慢性肾病患者的多参数功能性肾脏MRI技术显示髓质R2* 的时间变异性更高。这与36个月时观察到的髓质中R2* 显著低于基线值一致。线性混合模型的结果显示R2*_Medulla是与eGFR随时间变化相关的唯一预测因子。此外，在所有三个时间点均观察到髓质R2* 与eGFR的年度损失显著相关。随着时间的推移，肾髓质中较低的R2* 值和较高的时间变异性表明有能力监测进行性CKD。这一点得到了以下事实的证实：髓质R2* 降低与eGFR的年损失较高相关。这些数据共同强调了在肾脏BOLD MRI研究分析中纳入髓质的必要性。
The estimated glomerular filtration rate (eGFR) is frequently used to monitor progression of kidney disease. Multiple values have to be obtained, sometimes over years to determine the rate of decline in kidney function. Recent data suggest that functional MRI (fMRI) methods may be able to predict loss of eGFR. In a prior study, baseline data with multi-parametric MRI in individuals with diabetes and moderate chronic kidney disease (CKD) was reported. This report extends our prior observations in order to evaluate the temporal variability of the fMRI measurements over 36 months and their association with annual change in eGFR. Twenty-four subjects with moderate CKD completed three sets of MRI scans over a 36 month period. Blood oxygenation level dependent (BOLD), arterial spin labeling perfusion and diffusion MRI images were acquired using a 3T scanner. Coefficients of variation was used to evaluate variability between subjects at each time point and temporal variability within each subject. We have conducted mixed effects models to examine the trajectory change in GFR over time using time and MRI variables as fixed effects and baseline intercept as random effect. Associations of MRI image markers with annual change in eGFR were evaluated. Multi-parametric functional renal MRI techniques in individuals with moderate CKD showed higher temporal variability in R2* of medulla compared to healthy individuals. This was consistent with the significant lower R2* in medulla observed at 36 months compared to baseline values. The results of liner mixed model showing that R2*_Medulla was the only predictor associated with change in eGFR over time. Furthermore, a significant association of medullary R2* with annual loss of eGFR was observed at all the three time-points. The lower R2* values and the higher temporal variability in the renal medulla over time suggest the ability to monitor progressive CKD. These were confirmed by the fact that reduced medullary R2* was associated with higher annual loss in eGFR. These data collectively emphasize the need for inclusion of medulla in the analysis of renal BOLD MRI studies.
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影响因子：
6.7
作者：
Thacker JM;Li LP;Li W;Zhou Y;Sprague SM;Prasad PV
通讯作者：
Prasad PV
DOI：
10.1002/jmri.1880070633
发表时间：
1997-11-01
期刊：
JMRI-JOURNAL OF MAGNETIC RESONANCE IMAGING
影响因子：
--
作者：
Prasad, PV;Chen, Q;Edelman, RR
通讯作者：
Edelman, RR
影响因子：
3.3
作者：
Ordidge, RJ;Wylezinska, M;Franconi, F
通讯作者：
Franconi, F
影响因子：
4.4
作者：
Li, Lu-Ping;Thacker, Jon;Prasad, Pottumarthi
通讯作者：
Prasad, Pottumarthi
影响因子：
19.6
作者：
Fine, Leon G.;Norman, Jill T.
通讯作者：
Norman, Jill T.