Aurélie De Mul, Maxime Schleef, Guido Filler, Christopher McIntyre, Sandrine Lemoine
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Multi-nuclear MRI detects nuclei other than protons. <sup>23</sup>Na MRI enables visualization of the corticomedullary gradient and assessment of tissue sodium storage, which can be particularly relevant for personalized medicine in salt-wasting tubular disorders. Meanwhile, <sup>31</sup>P-MRS measures intracellular phosphate and ATP variations, providing insights into oxidative metabolism in the muscle during exercise and recovery. This technique can be useful for detecting subclinical ischemia in chronic kidney disease and in tubulopathies with kidney phosphate wasting. These techniques are non-invasive and do not involve radiation exposure, making them especially suitable for longitudinal and serial assessments. They enable in vivo evaluation of kidney function on a whole-organ basis within a short acquisition time and with the ability to distinguish between medullary and cortical compartments. Therefore, they offer considerable potential for pediatric patients. In this review, we provide a brief overview of the main imaging techniques, summarize available literature data on both adult and pediatric populations, and examine the perspectives and challenges associated with multi-parametric and multi-nuclear MRI.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"In vivo assessment of pediatric kidney function using multi-parametric and multi-nuclear functional magnetic resonance imaging: challenges, perspectives, and clinical applications.\",\"authors\":\"Aurélie De Mul, Maxime Schleef, Guido Filler, Christopher McIntyre, Sandrine Lemoine\",\"doi\":\"10.1007/s00467-024-06560-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The conventional methods for assessing kidney function, such as glomerular filtration rate and microalbuminuria, provide only partial insight into kidney function. 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引用次数: 0
摘要
评估肾功能的传统方法,如肾小球滤过率和微量白蛋白尿,只能部分了解肾功能。多参数和多核功能共振磁共振成像(MRI)技术是揭示肾脏生理机能的创新方法。多参数磁共振成像包括各种序列,用于评估肾脏灌注、组织氧合和微观结构特征,包括纤维化--急性和慢性肾病以及移植患者的主要病理现象--而无需进行侵入性肾活检。多核磁共振成像可检测质子以外的原子核。23Na 核磁共振成像可显示肾皮质髓质梯度并评估组织钠储存情况,这与盐耗竭性肾小管疾病的个性化医疗尤为相关。同时,31P-MRS 可测量细胞内磷酸盐和 ATP 的变化,从而了解肌肉在运动和恢复过程中的氧化代谢情况。这项技术可用于检测慢性肾病亚临床缺血和肾磷酸盐消耗性肾小管病。这些技术都是非侵入性的,不涉及辐射照射,因此特别适用于纵向和系列评估。它们能在短时间内对整个器官的肾功能进行活体评估,并能区分髓质和皮质部分。因此,它们为儿科患者提供了巨大的潜力。在这篇综述中,我们简要介绍了主要的成像技术,总结了成人和儿童人群的现有文献数据,并探讨了与多参数和多核磁共振成像相关的观点和挑战。
In vivo assessment of pediatric kidney function using multi-parametric and multi-nuclear functional magnetic resonance imaging: challenges, perspectives, and clinical applications.
The conventional methods for assessing kidney function, such as glomerular filtration rate and microalbuminuria, provide only partial insight into kidney function. Multi-parametric and multi-nuclear functional resonance magnetic imaging (MRI) techniques are innovative approaches to unraveling kidney physiology. Multi-parametric MRI includes various sequences to evaluate kidney perfusion, tissue oxygenation, and microstructure characterization, including fibrosis-a key pathological event in acute and chronic kidney disease and in transplant patients-without the need for invasive kidney biopsy. Multi-nuclear MRI detects nuclei other than protons. 23Na MRI enables visualization of the corticomedullary gradient and assessment of tissue sodium storage, which can be particularly relevant for personalized medicine in salt-wasting tubular disorders. Meanwhile, 31P-MRS measures intracellular phosphate and ATP variations, providing insights into oxidative metabolism in the muscle during exercise and recovery. This technique can be useful for detecting subclinical ischemia in chronic kidney disease and in tubulopathies with kidney phosphate wasting. These techniques are non-invasive and do not involve radiation exposure, making them especially suitable for longitudinal and serial assessments. They enable in vivo evaluation of kidney function on a whole-organ basis within a short acquisition time and with the ability to distinguish between medullary and cortical compartments. Therefore, they offer considerable potential for pediatric patients. In this review, we provide a brief overview of the main imaging techniques, summarize available literature data on both adult and pediatric populations, and examine the perspectives and challenges associated with multi-parametric and multi-nuclear MRI.
期刊介绍:
International Pediatric Nephrology Association
Pediatric Nephrology publishes original clinical research related to acute and chronic diseases that affect renal function, blood pressure, and fluid and electrolyte disorders in children. Studies may involve medical, surgical, nutritional, physiologic, biochemical, genetic, pathologic or immunologic aspects of disease, imaging techniques or consequences of acute or chronic kidney disease. There are 12 issues per year that contain Editorial Commentaries, Reviews, Educational Reviews, Original Articles, Brief Reports, Rapid Communications, Clinical Quizzes, and Letters to the Editors.