CAJ | 학술논문

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.
목적:응용자공진혈양수평의뢰성상(BOLD MRI)대급성신쇠신내적양대사진행평개.방법:20명지원자작위정상대조조,급성신쇠환자21례,기중소뇨기18례,비소뇨형1례,공능성급성신쇠갈2례.상규축위T2WI、T1WI이급BOLD MRI소묘.BOLD MRI위관상위16개제도회파서렬성상,분별측량신장적피질급수질적R2~*치이급계산수질여피질적R2~*비치,병장각조수거진행대비분석.결과:정상조신수질R2~*치(17.64±1.86)명현고우피질R2~*치(13.73±0.49),P<0.00,수피질R2~*치비치위1.28±0.06.급성신쇠소뇨조신피질R2~*치(12.25±2.41)화수질R2~*치(13.31±4.28)이급수피질비치(1.01±0.25),여정상조비교균감저,P<0.05.공능성급성신쇠갈여급성간질성신염비소뇨기환자적신피、수질R2~*치,이급수피질비치,균고우정상조.결론:신장BOLD MRI측량적R2~*치가평개신장급성신쇠시양대사적개변.재급성신쇠소뇨기,피질급수질내양적이용솔감저,수피질양농도제도차소실.
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,P<0.00).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.