功能磁共振成像在急性肾损伤中的应用及进展

    Progress and application of functional magnetic resonance imaging in acute kidney injury

    • 摘要: 急性肾损伤(acute kidney injury,AKI)是世界范围内高发的以肾功能突然恶化为特征的临床综合征,它发生在各种临床条件下,其严重程度与患者后续病死率增加、预后不良、肾脏损伤慢性化等密切相关。因此,早期识别AKI并干预至关重要。目前临床对于AKI诊断手法有限,缺少足够敏感且能够广泛应用的监测方法。功能磁共振成像作为一种日益发展的强大的成像模式,包括血氧水平依赖、动脉自旋标记、弥散加权成像、体素内不相干运动、弥散峰度成像、弥散张量成像、纵向弛豫时间定量、横向弛豫时间定量等技术,可以无创地评估肾脏氧合、血流灌注情况,并可以实时反映肾脏组织微结构的变化,具有及时发现AKI及预测AKI长期结局的潜能。本篇综述总结了近年来功能磁共振在AKI领域的相关研究,为未来临床应用提供参考。

       

      Abstract: Acute kidney injury (AKI) is a globally highly prevalent clinical syndrome characterized by a sudden deterioration of renal function. It occurs in a variety of clinical conditions and its severity is closely associated with increased subsequent mortality, poor prognosis, and chronicity of renal injury. Therefore, an early recognition of AKI and timely interventions are crucial. Currently, there are limited clinical diagnostic techniques for AKI, and there lacks sufficiently sensitive and widely available monitoring methods. Functional magnetic resonance imaging (fMRI) is an increasingly powerful imaging modality, including blood oxygenation level dependent (BOLD), arterial spin labeling (ASL), diffusion weighted imaging (DWI), intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), diffusion tensor imaging (DTI), and T1 mapping, T2 mapping, etc. These techniques can non-invasively assess renal oxygenation and perfusion, and reflect the changes in renal microstructure, providing the potential to detect AKI and predict the long-term outcome of AKI. This review summarized the recent studies of fMRI in AKI and provides a reference for future clinical applications.

       

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