Blood Oxygen Level-Dependent (BOLD) MRI in Renovascular Hypertension
Blood Oxygen Level-Dependent (BOLD) MRI in Renovascular Hypertension
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DOI：
10.1007/s11906-011-0218-7
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发表时间：
2011-10-01
影响因子：
5.6
通讯作者：
Textor, Stephen C.
中科院分区：
文献类型：
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作者：
Gloviczki, Monika L.;Lerman, Lilach O.;Textor, Stephen C.
确定大血管闭塞性疾病是否威胁狭窄后肾脏的组织氧合和活力对临床医生来说是困难的。血氧水平依赖（BOLD）MRI方法的发展可以在不需要造影剂的情况下对肾脏内脱氧血红蛋白水平的区域差异进行功能评价。复杂的肾循环通常提供从高度血管化的皮质到髓质深部的低得多的水平的氧合梯度，这取决于肾传入小动脉的调节、与溶质运输相关的氧消耗以及与下行和上行直血管的并列相关的动静脉分流。BOLD成像的研究已经确定了对狭窄后肾脏中肾血流量、体积和肾小球滤过率大幅降低的适应，其在药物治疗期间保留了髓质和皮质的氧合。然而，严重的血管损伤阻碍了这些适应性变化，并导致皮质缺氧和微血管损伤。
Establishing whether large vessel occlusive disease threatens tissue oxygenation and viability in the post-stenotic kidney is difficult for clinicians. Development of blood oxygen level-dependent (BOLD) MRI methods can allow functional evaluation of regional differences in deoxyhemoglobin levels within the kidney without requiring contrast. The complex renal circulation normally provides a gradient of oxygenation from a highly vascular cortex to much reduced levels in the deep sections of medulla, dependent upon adjustments in renal afferent arterioles, oxygen consumption related to solute transport, and arteriovenous shunting related to the juxtaposition of descending and ascending vasa recta. Studies with BOLD imaging have identified adaptation to substantial reductions in renal blood flow, volume, and glomerular filtration rate in post-stenotic kidneys that preserves medullary and cortical oxygenation during medical therapy. However, extreme vascular compromise overwhelms these adaptive changes and leads to cortical hypoxia and microvascular injury.