Gen Chen, Zhouyan Liao, Siyuan Ma, Pan Luo, Baodi Deng, Xiaoxiao Zhang, Qiuxia Wang, Hao Tang, Xia Lu, Xuemei Hu, Nianqiao Gong, Zhen Li
{"title":"功能性钠核磁共振测量皮质髓质钠含量及其在鉴别移植肾功能优劣中的作用。","authors":"Gen Chen, Zhouyan Liao, Siyuan Ma, Pan Luo, Baodi Deng, Xiaoxiao Zhang, Qiuxia Wang, Hao Tang, Xia Lu, Xuemei Hu, Nianqiao Gong, Zhen Li","doi":"10.1002/jmri.70001","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sodium MRI (<sup>23</sup>Na-MRI) measuring tissue sodium content may directly assess the corticomedullary gradient (CMG) in the kidney. However, it is understudied in transplanted kidneys.</p><p><strong>Purpose: </strong>To investigate associations between CMG in renal graft and urine concentrating ability, estimated glomerular filtration rate (eGFR), and biopsy-determined fibrosis scores, and to determine if CMG could differentiate between renal grafts with superior and inferior graft function.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Subjects: </strong>57 participants (39 males) with renal transplantation.</p><p><strong>Field strength/sequence: </strong>3D T2-weighted turbo spin echo sequence and <sup>23</sup>Na-MR imaging at 3 T.</p><p><strong>Assessment: </strong>Urine specific gravity and eGFR were assessed as measures of kidney function. Thirty-eight participants underwent biopsy within 2 days of MRI, and the Banff fibrosis score was assessed. The average medulla to cortex ratio (MCR) was determined from <sup>23</sup>Na-MRI analysis. Transplanted kidneys were divided into those with superior graft function (SGF, eGFR ≥ 45 mL/min/1.73 m<sup>2</sup>) and inferior graft function (IGF, eGFR < 45 mL/min/1.73 m<sup>2</sup>) groups.</p><p><strong>Statistical tests: </strong>Correlation analysis (Pearson or Spearman coefficient, r), intraclass correlation coefficient, and area under the receiver-operating characteristic curve (AUC).</p><p><strong>Results: </strong>MCR was 1.27 ± 0.11 and mean urine specific gravity was 1.013 ± 0.005. MCR was significantly correlated with mean urine specific gravity (r = 0.32) and with eGFR (r = 0.795). MCR distinguished IGF (n = 42) from SGF (n = 15) with an AUC of 0.851 (95% CI: 0.732, 0.931) with a cutoff of ≥ 1.295. MCR was significantly correlated with the Banff fibrosis score of tubulitis in areas of interstitial fibrosis and tubular atrophy (t-IFTA) (r = 0.347).</p><p><strong>Data conclusion: </strong><sup>23</sup>Na-MRI has the potential to show the CMG in transplanted kidneys, with MCR being correlated with urine concentrating ability. In addition, the transplanted kidney CMG was related to eGFR and the Banff fibrosis score t-IFTA.</p><p><strong>Evidence level: </strong>Level 2.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Functional Sodium MRI in the Measurement of Corticomedullary Sodium Content and Its Role in Differentiating Between Transplanted Kidneys With Superior and Inferior Graft Function.\",\"authors\":\"Gen Chen, Zhouyan Liao, Siyuan Ma, Pan Luo, Baodi Deng, Xiaoxiao Zhang, Qiuxia Wang, Hao Tang, Xia Lu, Xuemei Hu, Nianqiao Gong, Zhen Li\",\"doi\":\"10.1002/jmri.70001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Sodium MRI (<sup>23</sup>Na-MRI) measuring tissue sodium content may directly assess the corticomedullary gradient (CMG) in the kidney. However, it is understudied in transplanted kidneys.</p><p><strong>Purpose: </strong>To investigate associations between CMG in renal graft and urine concentrating ability, estimated glomerular filtration rate (eGFR), and biopsy-determined fibrosis scores, and to determine if CMG could differentiate between renal grafts with superior and inferior graft function.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Subjects: </strong>57 participants (39 males) with renal transplantation.</p><p><strong>Field strength/sequence: </strong>3D T2-weighted turbo spin echo sequence and <sup>23</sup>Na-MR imaging at 3 T.</p><p><strong>Assessment: </strong>Urine specific gravity and eGFR were assessed as measures of kidney function. Thirty-eight participants underwent biopsy within 2 days of MRI, and the Banff fibrosis score was assessed. The average medulla to cortex ratio (MCR) was determined from <sup>23</sup>Na-MRI analysis. Transplanted kidneys were divided into those with superior graft function (SGF, eGFR ≥ 45 mL/min/1.73 m<sup>2</sup>) and inferior graft function (IGF, eGFR < 45 mL/min/1.73 m<sup>2</sup>) groups.</p><p><strong>Statistical tests: </strong>Correlation analysis (Pearson or Spearman coefficient, r), intraclass correlation coefficient, and area under the receiver-operating characteristic curve (AUC).</p><p><strong>Results: </strong>MCR was 1.27 ± 0.11 and mean urine specific gravity was 1.013 ± 0.005. MCR was significantly correlated with mean urine specific gravity (r = 0.32) and with eGFR (r = 0.795). MCR distinguished IGF (n = 42) from SGF (n = 15) with an AUC of 0.851 (95% CI: 0.732, 0.931) with a cutoff of ≥ 1.295. MCR was significantly correlated with the Banff fibrosis score of tubulitis in areas of interstitial fibrosis and tubular atrophy (t-IFTA) (r = 0.347).</p><p><strong>Data conclusion: </strong><sup>23</sup>Na-MRI has the potential to show the CMG in transplanted kidneys, with MCR being correlated with urine concentrating ability. In addition, the transplanted kidney CMG was related to eGFR and the Banff fibrosis score t-IFTA.</p><p><strong>Evidence level: </strong>Level 2.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>\",\"PeriodicalId\":16140,\"journal\":{\"name\":\"Journal of Magnetic Resonance Imaging\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-06-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Magnetic Resonance Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jmri.70001\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.70001","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Functional Sodium MRI in the Measurement of Corticomedullary Sodium Content and Its Role in Differentiating Between Transplanted Kidneys With Superior and Inferior Graft Function.
Background: Sodium MRI (23Na-MRI) measuring tissue sodium content may directly assess the corticomedullary gradient (CMG) in the kidney. However, it is understudied in transplanted kidneys.
Purpose: To investigate associations between CMG in renal graft and urine concentrating ability, estimated glomerular filtration rate (eGFR), and biopsy-determined fibrosis scores, and to determine if CMG could differentiate between renal grafts with superior and inferior graft function.
Study type: Prospective.
Subjects: 57 participants (39 males) with renal transplantation.
Field strength/sequence: 3D T2-weighted turbo spin echo sequence and 23Na-MR imaging at 3 T.
Assessment: Urine specific gravity and eGFR were assessed as measures of kidney function. Thirty-eight participants underwent biopsy within 2 days of MRI, and the Banff fibrosis score was assessed. The average medulla to cortex ratio (MCR) was determined from 23Na-MRI analysis. Transplanted kidneys were divided into those with superior graft function (SGF, eGFR ≥ 45 mL/min/1.73 m2) and inferior graft function (IGF, eGFR < 45 mL/min/1.73 m2) groups.
Statistical tests: Correlation analysis (Pearson or Spearman coefficient, r), intraclass correlation coefficient, and area under the receiver-operating characteristic curve (AUC).
Results: MCR was 1.27 ± 0.11 and mean urine specific gravity was 1.013 ± 0.005. MCR was significantly correlated with mean urine specific gravity (r = 0.32) and with eGFR (r = 0.795). MCR distinguished IGF (n = 42) from SGF (n = 15) with an AUC of 0.851 (95% CI: 0.732, 0.931) with a cutoff of ≥ 1.295. MCR was significantly correlated with the Banff fibrosis score of tubulitis in areas of interstitial fibrosis and tubular atrophy (t-IFTA) (r = 0.347).
Data conclusion: 23Na-MRI has the potential to show the CMG in transplanted kidneys, with MCR being correlated with urine concentrating ability. In addition, the transplanted kidney CMG was related to eGFR and the Banff fibrosis score t-IFTA.
期刊介绍：
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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