Quantitative MRI and MR Elastography in Renal Transplants

肾移植中的定量 MRI 和 MR 弹性成像

• 批准号: 467843609
• 负责人: Privatdozent Dr. Stephan Marticorena Garcia
• 金额: --
• 依托单位: Klinik für Radiologie (mit dem Bereich Kinderradiologie) (CCM)
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2021
• 资助国家: 德国
• 起止时间: 2020-12-31 至 2022-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/467843609?language=en
• 关键词: Quantitative; MRI; MR; Elastography; Renal

Kidney transplantation is the only treatment that restores kidney function. The detection of acute transplant rejection, which occurs in 35% of all kidney recipients, is a major challenge during the early post-transplantation phase. Acute rejection is characterized by a strong immune response of the recipient against the donor kidney and often progresses subclinically. Early detection of acute rejection is essential for prompt initiation of immunosuppressive shock therapy to prevent complete transplant destruction. Invasive biopsy is the current reference standard for diagnosis of acute rejection. Noninvasive biomarkers such as creatinine from blood serum and urine output have been shown to be sensitive to structural renal tissue changes only at a late stage, often delaying clinical intervention. Conversely, quantitative magnetic resonance imaging (qMRI), including determination of perfusion by arterial spin labeling (ASL), oxygenation by blood-oxygenation-level-dependent (BOLD) MRI, diffusion by diffusion-weighted imaging (DWI), and viscoelasticity by magnetic resonance elastography (MRE), allows noninvasive assessment of the structural-functional properties of kidney transplants in vivo. For this reason, innovative qMRI and MRE parameters of native and transplant kidneys will be collected for the first time and tested for the clinical evaluation of kidney recipients with suspected acute kidney transplant rejection. For this purpose, native kidneys in healthy volunteers and living donors before explantation as well as transplant kidneys after implantation and in recipients with acute transplant rejection will be investigated by ASL, BOLD-MRI, DWI, and MRE. It is expected that the multiparametric analysis of the quantitative MRI data obtained with our protocols will allow conclusions to be drawn about early pathological functional-structural changes in kidney transplants and to thus improve therapeutic decision-making and clinical management of acute rejection episodes after kidney transplantation.

肾脏移植是恢复肾功能的唯一治疗方法。在所有肾脏受体中，发生在35％的急性移植排斥反应中，这是在移植后早期的主要挑战。急性排斥反应的特征是受体对供体肾脏的强烈免疫反应，并且经常在亚临床上进展。早期发现急性排斥反应对于迅速开始免疫抑制休克疗法以防止完全移植破坏至关重要。侵入性活检是诊断急性排斥反应的当前参考标准。无创的生物标志物，例如血清中的肌酐和尿量，仅在后期仅在后期敏感，对结构性肾脏组织的变化敏感，通常会延迟临床干预。 Conversely, quantitative magnetic resonance imaging (qMRI), including determination of perfusion by arterial spin labeling (ASL), oxygenation by blood-oxygenation-level-dependent (BOLD) MRI, diffusion by diffusion-weighted imaging (DWI), and viscoelasticity by magnetic resonance elastography (MRE), allows noninvasive assessment of the structural-functional properties of体内肾脏移植。因此，将首次收集天然肾脏和移植肾脏的创新QMRI和MRE参数，并测试以怀疑急性肾脏移植排斥反应的肾脏接受者的临床评估。为此，将研究ASL，Bold-MRI，DWI和MRE，研究植入后健康志愿者和活捐赠者的本地肾脏以及植入后的移植肾脏以及急性移植排斥的接受者。预计使用我们的方案获得的定量MRI数据的多参数分析将允许对肾脏移植的早期病理功能结构变化得出结论，从而改善肾脏移植后急性抑制事件的治疗决策和临床管理。