摘要
目的:应用磁共振血氧水平依赖成像(BOLD MRI)对急性肾衰肾内的氧代谢进行评价。方法:20名志愿者作为正常对照组,急性肾衰患者21例,其中少尿期18例,非少尿型1例,功能性急性肾衰竭2例。常规轴位T2WI、T1WI以及BOLD MRI扫描。BOLD MRI为冠状位16个梯度回波序列成像,分别测量肾脏的皮质及髓质的R2*值以及计算髓质与皮质的R2*比值,并将各组数据进行对比分析。结果:正常组肾髓质R2*值(17.64±1.86)明显高于皮质R2*值(13.73±0.49),P<0.00,髓皮质R2*值比值为1.28±0.06。急性肾衰少尿组肾皮质R2*值(12.25±2.41)和髓质R2*值(13.31±4.28)以及髓皮质比值(1.01±0.25),与正常组比较均减低,P<0.05。功能性急性肾衰竭与急性间质性肾炎非少尿期患者的肾皮、髓质R2*值,以及髓皮质比值,均高于正常组。结论:肾脏BOLD MRI测量的R2*值可评价肾脏急性肾衰时氧代谢的改变。在急性肾衰少尿期,皮质及髓质内氧的利用率减低,髓皮质氧浓度梯度差消失。
Objective: To assess the kidney oxygen bioavailability in acute renal failure using blood oxygen level dependent(BOLD) magnetic resonance(MR) imaging.Methods: Twenty-one patients with acute renal failure,including 18 patients with oliguric renal failure,1 nonoliguric acute renal failure and 2 functional renal failure were enrolled in the study;20 healthy subjects served as controls.All subjects received renal functional MR examination.BOLD MR imaging with 16 gradient-recalled-echoes on a 1.5-T scanner were performed.R2*(1/sec) values of the cortex and medulla and R2* ratio of the medulla to cortex(R2* ratio of M/C) of the renal were recorded respectively.Results: The R2* values of the medulla was higher than those of the cortex in controls(17.64±1.86/sec vs 13.73±0.49/sec,P0.00).The R2* ratio of M/C in controls was 1.28±0.06.The R2* values of the medulla(13.31±4.28/sec) and cortex(12.25±2.41/sec) and the R2* ratio of M/C(1.01±0.25) in oliguric renal failure were lower than those in controls(P 0.05).Patients with functional renal failure and nonoliguric acute renal failure had higher R2* values in cortex and medulla and higher R2* ratio of M/C than those of controls.Conclusion: BOLD MRI demonstrates that decreased R2* values of cortex and medulla suggest lower oxygen bioavailability in acute renal failure and decreased R2* ratio of M/C suggests the disappearance of a steep cortico-medullary gradient of oxygen.
出处
《浙江大学学报(医学版)》
CAS
CSCD
北大核心
2010年第2期157-162,共6页
Journal of Zhejiang University(Medical Sciences)
基金
国家自然科学基金(30770627)
浙江省科技厅重点科研社会发展项目(2006C23022)
浙江省自然科学基金(Y2007431)
浙江省医药卫生科技项目(2007A067)
浙江省中医药卫生科技项目(20080624)
关键词
肾功能衰竭
急性/病理学
磁共振成像/方法
氧/血液
氧/代谢
血氧水平依赖磁共振成像
Kidney failure
acute/pathol
Magnetic resonance imaging/methods
Oxygen/blood
Oxygen/metab
Blood oxygen level dependent magnetic resonance imaging