Functional MRI of the transplanted kidney

移植肾的功能 MRI

• 批准号: 7754363
• 负责人: ELIZABETH SADOWSKI
• 金额: $ 34.71万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7754363
• 关键词: Acute; Acute Kidney Tubular Necrosis; Allografting; Atrophic; Benefits and Risks; Biological Availability; Biological Markers; Biopsy; Blood flow; Caring; Diagnosis; Early Diagnosis; Fibrosis; Functional Magnetic Resonance Imaging; Functional disorder; Glomerular Filtration Rate; Goals; Graft Rejection; Hemorrhage; Infection; Kidney; Kidney Transplantation; Lead; Leucocytic infiltrate; Magnetic Resonance Imaging; Measurement; Measures; Nephrons; Oxidative Stress; Oxygen; Pain; Patients; Perfusion; Phase; Population; Postoperative Period; Procedures; Regional Blood Flow; Regional Perfusion; Sensitivity and Specificity; Serum; Subgroup; Time; Tissues; Transplant Recipients; Transplantation; Urine; Vasculitis; blood oxygen level dependent; blood perfusion; graft function; kidney allograft

DESCRIPTION (provided by applicant): Kidney transplantation has saved many lives since the first successful transplant more than 50 years ago. Although advances in surgical technique and immunosuppressive therapy have resulted in 1-year survival rates greater than 90%. graft dysfunction in the early post-transplant period occurs in up to 30% of transplant recipients. This is an important factor in the ultimate fate of the allograft, as acute rejection in those recipients with delayed graft function results in a 5-year graft survival of only 35%. This observation alone suggests that early diagnosis of acute rejection episodes is imperative if we are to limit nephron loss and maintain allograph function. Magnetic Resonance Imaging (MRI) is well-suited for assessing renal transplant anatomy and function. MRI uses non-nephrotoxic contrast agents and has the spatial resolution to independently assess different anatomical regions. New MR techniques, termed functional MRI, can assess the filtration capacity of glomeruli, regional blood flow within the kidney, and the oxygen bioavailability at the tissue level. To date, no other modality can combine techniques to provide such a comprehensive evaluation of the kidney. If MRI can non-invasively identify the underlying cause of dysfunction, we could potentially avoid biopsy and still target therapy appropriately. The R21 phase of this proposal focuses on optimizing MR perfusion, blood oxygen level dependent (BOLD) MRI, and single kidney filtration rate (skGFR) sequences. Repetitive measurements of MR perfusion, BOLD MRI and skGFR will be performed on adult volunteers in order to determine their reproducibility and natural variability. If successful, this proposal will result in a non-invasive method for evaluating kidney function, which then can be applied to the study of transplanted kidney dysfunction. The R33 phase of this proposal will utilize MR perfusion, BOLD MRI and skGFR in the differentiation of acute rejection from ATN in a population with delayed graft function. In addition to using functional MRI in the diagnosis of transplant dysfunction, we will streamline image analysis to reduce post-processing time and allow widespread clinical application of our techniques.

描述（由申请人提供）：自50年前第一次成功移植以来，肾脏移植已经挽救了许多生命。尽管手术技术和免疫抑制疗法的进步导致1年的存活率大于90％。移植后期早期的移植功能障碍发生在多达30％的移植受者中。这是同种异体移植的最终命运的重要因素，因为那些移植功能延迟的受体中的急性排斥反应导致5年移植物存活仅为35％。仅此观察结果就表明，如果我们要限制肾单位丧失并维持分类功能，则必须早期诊断急性排斥发作。磁共振成像（MRI）非常适合评估肾移植解剖和功能。 MRI使用非氯毒性对比剂，并具有空间分辨率来独立评估不同的解剖区域。新的MR技术称为功能性MRI，可以评估肾小球的过滤能力，肾脏内的区域血流以及组织水平的氧气生物利用度。迄今为止，没有其他方式可以结合技术来对肾脏进行如此全面的评估。如果MRI可以非侵入性地识别功能障碍的根本原因，我们可能会避免活检并仍然适当靶向治疗。该提案的R21阶段着重于优化MR灌注，血氧水平依赖性（BOLD）MRI和单肾过滤率（SKGFR）序列。为了确定其可重复性和自然变异性，将对成人志愿者进行重复的灌注，粗体MRI和SKGFR的重复测量。如果成功，该建议将导致一种评估肾脏功能的非侵入性方法，然后将其应用于移植肾功能障碍的研究。该提案的R33阶段将利用MR灌注，BOLD MRI和SKGFR来区分急性排斥反应与移植功能延迟的人群中的ATN。除了在诊断移植功能障碍的诊断中使用功能性MRI外，我们还将简化图像分析以减少后处理时间并允许广泛的临床应用。