Differentiation of delayed kidney graft function with gadolinium-DTPA-enhanced magnetic resonance imaging and Doppler ultrasound
Differentiation of delayed kidney graft function with gadolinium-DTPA-enhanced magnetic resonance imaging and Doppler ultrasound
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DOI：
10.1097/00004424-199606000-00009
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发表时间：
1996-06-01
影响因子：
6.7
通讯作者：
Horina, JH
中科院分区：
文献类型：
--
作者：
Preidler, KW;Szolar, D;Horina, JH
原理和说明。作者使用钆（Gd）-DTPA增强磁共振（MR）成像鉴别移植肾功能延迟恢复患者的急性肾小管坏死和移植排斥反应。对24例肾移植术后患者（10例移植肾功能正常，14例移植肾功能延迟恢复）进行常规超声、多普勒超声和MRI检查。在512秒的时间内，获得39个单层MR图像，测量三个感兴趣区域（皮质、髓质、肾盂）的信号强度，得到对比增强动力学的图形描述，测量扫描开始与曲线峰值之间的时间。在移植物功能正常的患者中，曲线在39 - 55秒（皮质）、44 - 61秒（髓质）和161 - 318秒之间达到峰值6例急性肾小管坏死患者的曲线1和2显示正常值，但曲线3明显延长在所有经组织学证实的移植排斥反应患者中，所有曲线的峰值在扫描结束前均未达到。作者的初步结果表明，磁共振成像似乎是一个敏感的，非侵入性的诊断船，以区分急性肾小管坏死和移植排斥反应在关键的早期手术后。
RATIONALE AND OBJECTIVES. The authors differentiate acute tubular necrosis from transplant rejection in patients with delayed kidney graft function using gadolinium (Gd)-DTPA enhanced magnetic resonance (MR) imaging.METHODS. Twenty-four patients after renal transplantation (10 with normal graft function, 14 with delayed graft function) underwent conventional and Doppler sonography and MR imaging examination after bolus application of Gd-DTPA. Within a time period of 512 seconds, 39 single-slice MR images were obtained, Measurements of signal intensity in three regions of interests (cortex, medulla, renal pelvis) resulted in a graphic description of the dynamics of the contrast enhancement, The time between the start of the scan and the peaks of the curves was measured,RESULTS. In patients with normal graft function the curves reached the peaks between 39 and 55 seconds (cortex), 44 and 61 seconds (medulla), and between 161 and 318 seconds (renal pelvis), Six patients with acute tubular necrosis showed normal values for the curves 1 and 2 but markedly prolonged time for curve 3 (between 420 and 512 seconds), In all patients with histologically proven transplant rejection, the peaks of all curves were not reached before the ends of the scans.CONCLUSION. The authors' preliminary results suggest that MR imaging seems to be a sensitive, noninvasive diagnostic boat to differentiate acute tubular necrosis from transplant rejection in the critical early postoperative period.