Journal Article

The significance of BOLD MRI in differentiation between renal transplant rejection and acute tubular necrosis

Fei Han, Wenbo Xiao, Ying Xu, Jianyong Wu, Qidong Wang, Huiping Wang, Minming Zhang and Jianghua Chen

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 23, issue 8, pages 2666-2672
Published in print August 2008 | ISSN: 0931-0509
Published online February 2008 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfn064
The significance of BOLD MRI in differentiation between renal transplant rejection and acute tubular necrosis

Show Summary Details

Preview

Background. Blood oxygen level-dependent MRI (BOLD MRI) can be used to assess intra-renal oxygen bioavailability by measuring the R2* level, which reflects tissue deoxyhaemoglobin levels. This study was designed to identify the significance of BOLD MRI in differentiation of acute rejection (AR) and acute tubular necrosis (ATN) in patients within 6 months after kidney transplantation.

Methods. Eighty-two patients with normal graft function and 28 patients with biopsy-proven AR (n = 21) or ATN (n = 7) were enrolled. Patients with normal functioning allograft underwent BOLD MRI within 2 to 3 weeks post-transplantation, while patients with AR and ATN underwent BOLD MRI within 6 days before or after kidney transplant biopsy. Cortical R2* (CR2*) and medullary R2* (MR2*) levels were measured.

Results. The mean CR2* level was significantly higher in the ATN group (15.25 ± 1.03/s) compared to the normal group (13.35 ± 2.31/s, P = 0.028) and AR group (12.02 ± 1.72/s, P = 0.001). There was a significant difference also between the AR group and normal group on CR2* levels (P = 0.013). The mean MR2* level was significantly lower in the AR group (14.02 ± 2.68/s) compared to the normal group (16.66 ± 2.82/s, P < 0.001) and ATN group (19.47 ± 1.62/s, P < 0.001). There was also a significant difference between the ATN group and normal group on MR2* levels (P = 0.011). There were no correlations between characteristics such as patient age, post-operation time, post-biopsy time, Scr level, HB level, urine output volume, MAP level, CNI trough concentration and R2* levels, except between MAP level and CR2* level (P = 0.029).

Conclusions. BOLD MRI could be a valuable method to discriminate between AR and ATN by measuring tissue oxygen bioavailability in early kidney allograft dysfunction.

Keywords: acute rejection; acute tubular necrosis; kidney transplantation; magnetic resonance imaging (MRI); oxygen bioavailability

Journal Article.  3845 words.  Illustrated.

Subjects: Nephrology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.