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首页> 外文期刊>Acta physiologica >How bold is blood oxygenation level-dependent (BOLD) magnetic resonance imaging of the kidney? Opportunities, challenges and future directions
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How bold is blood oxygenation level-dependent (BOLD) magnetic resonance imaging of the kidney? Opportunities, challenges and future directions

机译：肾脏的血液氧合水平依赖性（BOLD）磁共振成像有多大胆？机遇，挑战和未来方向

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Renal tissue hypoperfusion and hypoxia are key elements in the pathophysiology of acute kidney injury and its progression to chronic kidney disease. Yet, in vivo assessment of renal haemodynamics and tissue oxygenation remains a challenge. Many of the established approaches are invasive, hence not applicable in humans. Blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) offers an alternative. BOLD-MRI is non-invasive and indicative of renal tissue oxygenation. Nonetheless, recent (pre-) clinical studies revived the question as to how bold renal BOLD-MRI really is. This review aimed to deliver some answers. It is designed to inspire the renal physiology, nephrology and imaging communities to foster explorations into the assessment of renal oxygenation and haemodynamics by exploiting the powers of MRI. For this purpose, the specifics of renal oxygenation and perfusion are outlined. The fundamentals of BOLD-MRI are summarized. The link between tissue oxygenation and the oxygenation-sensitive MR biomarker T-2* is outlined. The merits and limitations of renal BOLD-MRI in animal and human studies are surveyed together with their clinical implications. Explorations into detailing the relation between renal T-2* and renal tissue partial pressure of oxygen (pO(2)) are discussed with a focus on factors confounding the T-2* vs. tissue pO(2) relation. Multi-modality in vivo approaches suitable for detailing the role of the confounding factors that govern T-2* are considered. A schematic approach describing the link between renal perfusion, oxygenation, tissue compartments and renal T-2* is proposed. Future directions of MRI assessment of renal oxygenation and perfusion are explored.
机译：肾脏组织灌注不足和缺氧是急性肾脏损伤及其进展为慢性肾脏疾病的病理生理学的关键因素。然而，体内对肾血流动力学和组织氧合的评估仍然是一个挑战。许多已建立的方法都是侵入性的，因此不适用于人类。血液氧合水平依赖性（BOLD）磁共振成像（MRI）提供了另一种选择。 BOLD-MRI是非侵入性的，可指示肾组织氧合。尽管如此，最近的（临床前）临床研究使人们质疑了肾脏BOLD-MRI到底有多大胆。这篇评论旨在提供一些答案。它旨在激发肾脏生理学，肾脏病学和影像学界，以利用MRI的力量促进对肾脏氧合和血流动力学评估的探索。为此，概述了肾脏氧合和灌注的细节。总结了BOLD-MRI的基本原理。概述了组织氧合与氧合敏感性MR生物标志物T-2 *之间的联系。对肾脏BOLD-MRI在动物和人体研究中的优缺点进行了研究，并对其临床意义进行了调查。讨论了详细探讨肾脏T-2 *与肾脏组织氧分压（pO（2））之间关系的探索，重点是混淆了T-2 *与组织pO（2）关系的因素。考虑了适用于详细阐明控制T-2 *的混杂因素作用的体内多模态方法。提出了一种描述肾脏灌注，氧合作用，组织区室和肾脏T-2 *之间联系的示意方法。探索了肾脏氧合和灌注的MRI评估的未来方向。

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