CAJ | 학술논문

目的：探讨正常肾脏的血氧水平依赖磁共振（BOLD-MRI）成像特点，以及与部分生理指标之间的相关性。方法纳入90例行腹部磁共振检查的非肾脏病患者。使用GE 3.0 T磁共振扫描仪和Torsopa相控阵线圈，行肾脏冠状面T1WI及BOLD成像，BOLD-MRI成像扫描采用T2*自旋梯度回波（T2*SPGR）序列，BOLD影像分析采用R2*map后处理软件，分别从肾脏皮质和髓质区选取感兴趣区（ROI）测量表观自旋-自旋弛豫率(R2*)值。分析R2*值与患者年龄、性别、身高、体质量、体质量指数（BMI）、体表面积（BSA）和估算的肾小球滤过率（eGFR）之间的相关性。结果两侧肾脏皮质区R2*值[左侧（16.56±1.40）Hz和右侧（16.66±1.28）Hz]均低于相应髓质区[左侧（28.82±3.71）Hz和右侧（28.36±3.72）Hz]；女性和男性患者皮质R2*值[女性（16.55±1.30）Hz和男性（16.66±1.38Hz）]也低于相应的髓质区[女性（28.46±3.64）Hz和男性（28.70±3.78）Hz]。双侧肾脏髓质区肾脏下极R2*值[（27.29±3.05）]Hz低于中极[（29.32±3.47）Hz]和上极[（29.16±4.21）Hz]；差异均有统计学意义。髓质R2*值与年龄呈正相关，与eGFR呈负相关(r分别为0.284、-0.232,均P<0.05)。结论 R2*值可反映肾脏皮髓质氧分压的水平，判断其缺血缺氧程度。BOLD-MRI提供了一种简单、易行且无创性检测肾脏皮髓质氧代谢的方法。
목적：탐토정상신장적혈양수평의뢰자공진（BOLD-MRI）성상특점，이급여부분생리지표지간적상관성。방법납입90례행복부자공진검사적비신장병환자。사용GE 3.0 T자공진소묘의화Torsopa상공진선권，행신장관상면T1WI급BOLD성상，BOLD-MRI성상소묘채용T2*자선제도회파（T2*SPGR）서렬，BOLD영상분석채용R2*map후처리연건，분별종신장피질화수질구선취감흥취구（ROI）측량표관자선-자선이예솔(R2*)치。분석R2*치여환자년령、성별、신고、체질량、체질량지수（BMI）、체표면적（BSA）화고산적신소구려과솔（eGFR）지간적상관성。결과량측신장피질구R2*치[좌측（16.56±1.40）Hz화우측（16.66±1.28）Hz]균저우상응수질구[좌측（28.82±3.71）Hz화우측（28.36±3.72）Hz]；녀성화남성환자피질R2*치[녀성（16.55±1.30）Hz화남성（16.66±1.38Hz）]야저우상응적수질구[녀성（28.46±3.64）Hz화남성（28.70±3.78）Hz]。쌍측신장수질구신장하겁R2*치[（27.29±3.05）]Hz저우중겁[（29.32±3.47）Hz]화상겁[（29.16±4.21）Hz]；차이균유통계학의의。수질R2*치여년령정정상관，여eGFR정부상관(r분별위0.284、-0.232,균P<0.05)。결론 R2*치가반영신장피수질양분압적수평，판단기결혈결양정도。BOLD-MRI제공료일충간단、역행차무창성검측신장피수질양대사적방법。
Objective To explore the characteristics of blood oxygen level dependent (BOLD) magnetic resonance imaging (MRI) in healthy native kidneys. To investigate the relationship between BOLD-MRI and common physiological in-dexes. Methods GE 3.0T MRI scanner and Torsopa phased-array coil were employed to acquire renal coronal T1WI and BOLD image. Ninety patients who were ruled out chronic kidney diseases underwent BOLD-MRI with T2*-spoiled gradient recalled echo (T2*SPGR) sequence. BOLD images were analyzed on R2*map software. Cortical and medullary R2*values were analyzed in bilateral kidneys and in different gender. Different regional R2*values in cortex and medulla were also ana-lyzed. Physiological indices including age, body height and weight, body mass index (BMI), body surface area (BSA), estimat-ed glomerular filtration rate (eGFR) were recorded. Correlation between R2*value and physiological indices were analyzed. Results Bilateral renal cortical R2*values [left (16.56±1.40) Hz and right (16.66±1.28)Hz, respectively] were less than val-ues in medulla [left (28.82±3.71)Hz and right (28.36±3.72)Hz, respectively]. Female and male cortical R2*values [female (16.55±1.30Hz) and male (16.66±1.38)Hz, respectively] were also less than corresponding values in medulla [female (28.46± 3.64) Hz and male (28.70±3.78) Hz, respectively]. In bilateral renal medullary region, R2*values in low pole (27.29±3.05) Hz was less than values in middle (29.32±3.47) Hz and upper pole (29.16±4.21)Hz (F=15.184, P<0.001). Age was positive-ly correlated with R2* values in medulla (r =0.284, P =0.002). However, eGFR was negatively correlated with medullary R2*value (r=-0.232, P=0.007). Conclusion R2*values reflected the levels of renal partial pressure of oxygen and as-sessed the degree of renal ischemia. BOLD MRI could offer a simple, convenient and noninvasive method for to evaluate renal oxygen metabolism in cortex and medulla.