Kidney morphological parameters measured using noncontrast-enhanced steady-state free precession MRI with spatially selective inversion recovery pulse correlate with eGFR in patients with advanced CKD.
Kidney morphological parameters measured using noncontrast-enhanced steady-state free precession MRI with spatially selective inversion recovery pulse correlate with eGFR in patients with advanced CKD.
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DOI：
10.1007/s10157-017-1413-x
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发表时间：
2018-03
影响因子：
2.3
通讯作者：
Narita I
中科院分区：
文献类型：
--
作者：
Otsuka T;Kaneko Y;Sato Y;Kaseda R;Aoyagi R;Yamamoto S;Goto S;Narita I
众所周知，萎缩性肾脏变化与慢性肾脏疾病（CKD）进展相关，但常规诊断成像方法，如非对比增强计算机断层扫描和磁共振成像（MRI），已不足以精确评估肾功能，因为它们不能清楚地区分髓质和皮质。因此，在这里，我们使用非对比增强稳态自由进动（SSFP）MRI与空间选择性反转恢复（IR）脉冲，以提高肾脏皮髓质分化的可见性，并评估CKD患者的形态参数和肾功能之间的关联。使用SSFP MRI和空间选择性IR脉冲测量107例CKD G1-G5患者的肾皮质髓质对比度、皮质和髓质面积以及最小皮质厚度，并评价这些形态学参数与肾功能之间的相关性。与传统的同相T1加权梯度回波MRI相比，SSFP MRI的皮髓质对比度显著改善，并与估计的肾小球滤过率（eGFR）、原始eGFR和24小时肌酐清除率呈正相关。肾髓质面积、皮质面积和最小皮质厚度与肾功能指标和年龄呈正相关。在CKD合并糖尿病（DM）患者中，原始eGFR与形态学参数之间的相关系数高于非DM患者，而原始eGFR ≥ 45 mL/min的CKD合并DM患者的最小皮质厚度较大。在CKD患者中，包括晚期肾功能不全患者，采用SSFP MRI测量的肾脏形态学参数与肾功能明显相关。
It is well known that atrophic renal changes are associated with chronic kidney disease (CKD) progression, but conventional diagnostic imaging methods such as noncontrast-enhanced computed tomography and magnetic resonance imaging (MRI) have been insufficient for precisely assessing kidney function because they cannot clearly distinguish between the medulla and cortex. Hence, here we used noncontrast-enhanced steady-state free precession (SSFP) MRI with a spatially selective inversion recovery (IR) pulse to improve visibility for renal corticomedullary differentiation and evaluated the association between morphological parameters and kidney function in patients with CKD. Kidney corticomedullary contrast ratio, cortical and medullary areas, and minimal cortical thickness of 107 patients with CKD G1–G5 were measured using SSFP MRI with a spatially selective IR pulse and the association between these morphological parameters and kidney function were evaluated. Corticomedullary contrast ratio was significantly improved on SSFP MRI compared with conventional in-phase T1-weighted gradient-echo MRI and positively correlated with estimated glomerular filtration ratio (eGFR), raw eGFR, and 24-h creatinine clearance. The medullary and cortical areas and minimal cortical thickness also positively correlated with those of kidney functional markers and the age. In patients with CKD and diabetes mellitus (DM), the correlation coefficients between raw eGFR and morphological parameters were higher than those in patients without DM, while minimal cortical thickness was larger in CKD patients with DM with a raw eGFR ≥ 45 mL/min. Kidney morphological parameters measured with SSFP MRI were clearly correlated with kidney function in patients with CKD, including those with advanced kidney dysfunction.
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影响因子：
--
作者：
Du Bois, D;Du Bois, EF
通讯作者：
Du Bois, EF
影响因子：
3
作者：
Kanki, Akihiko;Ito, Katsuyoshi;Yoshida, Koji
通讯作者：
Yoshida, Koji
影响因子：
19.6
作者：
Wang, Xiangling;Vrtiska, Terri J.;Avula, Ramesh T.;Walters, Leah R.;Chakkera, Harini A.;Kremers, Walter K.;Lerman, Lilach O.;Rule, Andrew D.
通讯作者：
Rule, Andrew D.
影响因子：
--
作者：
Garasto S;Fusco S;Corica F;Rosignuolo M;Marino A;Montesanto A;De Rango F;Maggio M;Mari V;Corsonello A;Lattanzio F
通讯作者：
Lattanzio F
影响因子：
13.2
作者：
Matsuo, Seiichi;Imai, Enyu;Hishida, Akira
通讯作者：
Hishida, Akira