Noninvasive evaluation of renal oxygenation in diabetic nephropathy by BOLD-MRI

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• 作者：Wen-Jie Yin^a ; ^{yin-wenjie@163.com} ; Fang Liu^b ; ^{liufangfh@163.com} ; Xiao-Mei Li^c ; ^{lixiaomei@yahoo.cn} ; Ling Yang^a ; ^{florialinda@163.com} ; Shuang Zhao^a ; ^{tracy_0924@163.com} ; Zi-Xing Huang^a ; You-Qun Huang^b ; Rong-Bo Liu^a ; ^{rongbol@126.com}
• 关键词：Kidney ; Hypoxia ; Bold-MRI ; Diabetic nephropathy ; Diabetes
• 刊名：European Journal of Radiology
• 出版年：2012
• 期刊代码：93_0720048x
• 类别：med
• 出版时间：July, 2012
• 卷：81
• 期：7
• 页码：1426-1431
• 文件大小：644 K

摘要

Purpose

To evaluate the renal oxygenation in type 2 diabetes by blood oxygenation level dependent magnetic resonance imaging (BOLD-MRI).

Materials and methods

Forty-eight patients with type 2 diabetes and 67 healthy controls were recruited. All patients were further divided into four subgroups based on renal functional level. Bilateral renal cortical R2* (CR2*) and medullary R2* (MR2*) values were extracted and quantified on BOLD-MRI, then R2* ratio between medulla and cortex (MCR) was calculated. CR2*, MR2* and MCR were compared among the groups separately. The relationships were analyzed between R2* values and clinical index of renal function.

Results

Compared with controls, MR2* and CR2* in diabetes were significantly increased. The positive relationship was found between MR2* and estimated glomerular filtration rate (eGFR), and CR2* was negatively correlated with eGFR. Interestingly, the MCR increased in early stage of diabetes and decreased along with the aggravation of diabetic nephropathy (DN).

Conclusion

BOLD-MRI can non-invasively detect and assess the renal hypoxia in diabetes. Our findings suggest that hypoxia in medulla is more apparent and earlier than in cortex. During the progression of DN, a reversion of corticomedullary oxygenation gradient can be detected, thus, MCR would be adopted to suppose the progression and prognosis of DN.