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.

肾移植是恢复肾功能的唯一治疗方法。急性移植排斥反应发生在所有肾脏受者中的 35%，其检测是移植后早期的一项重大挑战。急性排斥反应的特点是受者对供体肾脏产生强烈的免疫反应，并且常常呈亚临床进展。早期发现急性排斥反应对于及时启动免疫抑制休克疗法以防止移植物完全破坏至关重要。侵入性活检是目前诊断急性排斥反应的参考标准。无创生物标志物，例如血清中的肌酐和尿量，已被证明仅在晚期才对肾组织结构变化敏感，通常会延迟临床干预。相反，定量磁共振成像 (qMRI)，包括通过动脉自旋标记 (ASL) 测定灌注、通过血氧水平依赖 (BOLD) MRI 测定氧合、通过扩散加权成像 (DWI) 测定扩散以及通过磁力测定粘弹性共振弹性成像（MRE）可以对体内肾移植的结构功能特性进行无创评估。为此，将首次收集自体肾和移植肾的创新 qMRI 和 MRE 参数并进行测试，用于对疑似急性肾移植排斥的肾受者进行临床评估。为此，将通过 ASL、BOLD-MRI、DWI 和 MRE 对健康志愿者和活体捐献者的移植前肾脏、植入后的移植肾脏以及患有急性移植排斥的受者的肾脏进行研究。预计通过我们的方案获得的定量 MRI 数据的多参数分析将能够得出有关肾移植早期病理功能结构变化的结论，从而改善肾移植后急性排斥反应的治疗决策和临床管理。