多参数磁共振影像在评估肾脏纤维化中的应用  

Multiparameter magnetic resonance imaging for the assessment of renal fibrosis

作　　者：张炯[1] 刘志红[1] ZHANG Jiong;LIU Zhihong(The Second Military Medical University,National Clinical Research Center of Kidney Diseases,Jinling Hospital,Nanjing 210016,China)

机构地区：[1]第二军医大学金陵医院(东部战区总医院)国家肾脏疾病临床医学研究中心全军肾脏病研究所

出　　处：《肾脏病与透析肾移植杂志》2018年第6期555-559,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：国家重点研发计划(2018YFC1312700);国家自然科学基金(81701722)

摘　　要：肾脏纤维化是慢性肾脏病进展的重要病理标志,在此过程中伴随着肾脏微循环状态的改变、组织缺氧、肾单位毁损。评估肾脏纤维化程度对了解肾脏病病情、判断预后及制定治疗方案非常有意义。目前临床上缺乏对肾组织纤维化病变的非侵入性检查措施,现今的主要诊断依据,金标准仍然是经皮肾穿刺组织活检。活检的不足不仅为创伤性检查,还存在取材的局限性。近来开发的一些影像学技术成功地应用于临床,用来评估组织纤维化程度。本综述主要围绕肾组织纤维化病变,针对慢性肾病肾组织微循环改变和纤维化组织硬度改变的特点,介绍新型的多参数磁共振成像技术对肾组织纤维化程度评估的研究进展和临床应用。A key contributor to the progression of nearly all forms of chronic kidney diseases is fibrosis,a largely irreversible process that drives further kidney injury. Accompany with fibrosis in kidney are microcirculation disorder,hypoxia,nephron losing,etc.However,despite its importance,clinicians currently have no means of noninvasively assessing above lesions,except historically relied on percutaneous renal biopsy.Renal biopsy is limited not only by its invasiveness,but also,because of the small amounts of tissue analyzed which leads to sampling bias.Recent advances in imaging technology have raised the exciting possibility of magnetic resonance imaging by capitalizing on the evaluating physical features of fibrotic and nonfibrotic tissue. In this review,we describe two key fibrosis-induced pathologic changes( capillary loss and kidney stiffening) that can be imaged by MRI techniques,and the potential for thesenew multiparameter MRI-based technologies to noninvasively examination.

关 键 词：肾脏纤维化 肾活检 微血管 多参数磁共振 分子影像 

分 类 号：R692[医药卫生—泌尿科学]