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首页> 外文期刊>Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association - European Renal Association >Magnetic resonance imaging T-1- and T-2-mapping to assess renal structure and function: a systematic review and statement paper
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Magnetic resonance imaging T-1- and T-2-mapping to assess renal structure and function: a systematic review and statement paper

机译：磁共振成像T-1和T-2绘图，以评估肾结构结构和功能：系统审查和陈述论文

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摘要

This systematic review, initiated by the European Cooperation in Science and Technology Action Magnetic Resonance Imaging Biomarkers for Chronic Kidney Disease (PARENCHIMA), focuses on potential clinical applications of magnetic resonance imaging in renal non-tumour disease using magnetic resonance relaxometry (MRR), specifically, the measurement of the independent quantitative magnetic resonance relaxation times T-1 and T-2 at 1.5 and 3Tesla (T), respectively. Healthy subjects show a distinguishable cortico-medullary differentiation (CMD) in T-1 and a slight CMD in T-2. Increased cortical T-1 values, that is, reduced T-1 CMD, were reported in acute allograft rejection (AAR) and diminished T-1 CMD in chronic allograft rejection. However, ambiguous findings were reported and AAR could not be sufficiently differentiated from acute tubular necrosis and cyclosporine nephrotoxicity. Despite this, one recent quantitative study showed in renal transplants a direct correlation between fibrosis and T-1 CMD. Additionally, various renal diseases, including renal transplants, showed a moderate to strong correlation between T-1 CMD and renal function. Recent T-2 studies observed increased values in renal transplants compared with healthy subjects and in early-stage autosomal dominant polycystic kidney disease (ADPKD), which could improve diagnosis and progression assessment compared with total kidney volume alone in early-stage ADPKD. Renal MRR is suggested to be sensitive to renal perfusion, ischaemia/oxygenation, oedema, fibrosis, hydration and comorbidities, which reduce specificity. Due to the lack of standardization in patient preparation, acquisition protocols and adequate patient selection, no widely accepted reference values are currently available. Therefore this review encourages efforts to optimize and standardize (multi-parametric) protocols to increase specificity and to tap the full potential of renal MRR in future research.
机译：这种系统审查，由欧洲科学和技术作用磁共振成像生物标志物发起的慢性肾病（Parenchima），专注于使用磁共振弛豫（MRR）肾非肿瘤疾病磁共振成像的潜在临床应用，分别测量自定量磁共振弛豫时间T-1和T-2，分别为1.5和3TESLA（T）。健康受试者在T-1中显示可区分的皮质髓质分化（CMD）和T-2中的微小CMD。增加了皮质T-1值，即减少T-1 CMD，在急性同种异体移植抑制（AAR）中报道并在慢性同种异体移植物排出中减少T-1 CMD。然而，报告了含糊不清的结果，并且可以从急性管状坏死和环孢菌素肾毒性中充分地分化AAR。尽管如此，最近的一项定量研究表明，肾移植纤维化和T-1 CMD之间的直接相关性。此外，包括肾移植在内的各种肾脏疾病表明T-1 CMD和肾功能之间的相对强度相关性。与健康受试者和早期常染色体显性多囊肾病（ADPKD）相比，最近的T-2研究观察到肾移植量增加，与单独的早期ADPKD中单独的肾脏总量相比，可以改善诊断和进展评估。建议肾MRR对肾灌注，缺血/氧合，水肿，纤维化，水合和合并症进行敏感，这减少了特异性。由于患者准备，采集协议和适当的患者选择缺乏标准化，目前没有广泛接受的参考值。因此，这篇综述鼓励努力优化和标准化（多参数）协议以增加特异性，并在未来的研究中挖掘肾MRR的全部潜力。

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