Functional Magnetic Resonance Imaging of the Kidneys-With and Without Gadolinium-Based Contrast.
Functional Magnetic Resonance Imaging of the Kidneys-With and Without Gadolinium-Based Contrast.
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DOI：
10.1053/j.ackd.2017.03.006
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发表时间：
2017-05
影响因子：
2.9
通讯作者：
Zhang JL
中科院分区：
文献类型：
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作者：
Zhang JL
在过去的十年中，磁共振成像（MRI）评估肾功能已被积极探索。本文介绍了MRI的基本原理，综述了MRI增强和非增强两种方法在肾功能评价中的最新进展。使用超低剂量钆基剂的对比增强MRI已被验证可准确测量单肾肾小球滤过率（GFR）和肾血浆流量（RPF）。对于常规功能检查，MRI增强扫描不能代替单纯的血清肌酐法。然而，对于患有肾脏疾病的患者，通常值得进行MRI以准确地监测肾功能，特别是对于患病的肾脏。由于对比增强MRI已经是表征肾脏结构异常（包括肾脏肿块和输尿管梗阻）的既定临床工具，因此有可能调整临床MRI方案以测量单肾GFR和RPF，如最近的研究所示。MRI的独特之处在于其非造影方法的前景。这些方法包括用于组织灌注的动脉自旋标记（ASL）、用于血液和组织氧合的血氧水平依赖（BOLD）以及用于水扩散的扩散加权成像（DWI）。对于每种方法，我们回顾了最近的发现，并总结了挑战。
Assessment of renal function with magnetic resonance imaging (MRI) has been actively explored in the past decade. In this review, we introduce the principle of MRI, and review recent progress of MRI methods (contrast-enhanced and non-contrast) in assessing renal function. Contrast-enhanced MRI using ultra-low dose of gadolinium-based agent has been validated for measuring single-kidney glomerular filtration rate (GFR) and renal plasma flow (RPF) accurately. For routine functional test, contrast-enhanced MRI may not replace the simple serum-creatinine method. However, for patients with renal diseases, it is often worthy to perform MRI to accurately monitor renal function, particularly for the diseased kidney. As contrast-enhanced MRI is already an established clinical tool for characterizing renal structural abnormalities, including renal mass and ureteral obstruction, it is possible to adapt the clinical MRI protocol to measure single-kidney GFR and RPF, as demonstrated by recent studies. What makes MRI unique is the promise of its non-contrast methods. These methods include arterial spin labeling (ASL) for tissue perfusion, blood oxygen level dependent (BOLD) for blood and tissue oxygenation, and diffusion weighted imaging (DWI) for water diffusion. For each method, we reviewed recent findings, and summarized challenges.