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• Clinical Article •
Value of BOLD-fMRI to transplanted kidneys with acute rejection: a preliminary study
HUANG Hai-bo  HUANG Gui-xiong  LIU Xu-yang  GUAN Jun  QIN Ming  LI Da-chuang  YANG Jian-jun 

DOI:10.12015/issn.1674-8034.2016.06.009.


[Abstract] Objective: To explore the value of BOLD-fMRI to early diagnose transplanted kidneys with acute rejection.Materials and Methods: Study protocol was approved by local ethics committee; informed consent was obtained. A MR special model which included fifteen vials containing 0-3.2 mM manganese chloride in hydrochloric acid solution, and a total of 100 velunteers were enrolled and divided into three groups, as follows: Group A, 51 cases with healthy kidneys in situ; group B, 34 transplantation with stable renal function for at least 3 months after operating; and group C, 15 iliac renal allografts with early acute rejection from 1 week to 4 weeks after operating. T2W axial/coronal, T1W coronal and a coronal fat-saturated multiecho GRE with 12 echos (9.2-53.2 ms) were performed on a 3.0 T scanner during normal breathing or breath-holding. CMR tools was used to calculate the value of R2* in MR model vias, renal cortex, medulla respectively after MRI. Receiver operating characteristic (ROC) curve was used to predict the kidneys with early acute rejection and threshold R2* value were identified to discriminate between transplanted kidneys with acute rejection, those with normal function, and healthy native renals.Results: No statistical significances were found for R2* values among repeated scanning on phantom (P>0.05). The value of R2* (Hz) on renal medulla(19.36±3.94) with acute rejection was significantly lower than those of medulla both in group A(29.73±2.92) and B(29.80±2.75) (P<0.05), however no statistical significances were found between group A and B(P>0.05), and for R2* on renal cortex among three groups(P>0.05). The value of R2* on medulla was higher than those on cortex both group A and B, moreover no statistical significance was found for R2* between left and right kidney in situ(P>0.05). With a medullary R2* =24.67 Hz as diagnose critical points compared to bilpsy, the sensibility was 86.7%, the specificity was 98.5%, and the accuracy was 0.975 in the prediction of kidneys with early acute rejection.Conclusion: BOLD-fMRI is of important value in the diagnosis of renals with early-stage acute rejection.
[Keywords] Kidney transplantation；Graft rejection；Blood oxygen level dependent；Magnetic resonance imaging, functional；Diagnostic imaging

HUANG Hai-bo Department of Medical Imaging, 303rd Hospital of PLA, Nanning 530021, China

HUANG Gui-xiong* Department of Medical Imaging, 303rd Hospital of PLA, Nanning 530021, China

LIU Xu-yang Department of Transplantation, 303rd Hospital of PLA, Nanning 530021, China

GUAN Jun Department of Medical Imaging, 303rd Hospital of PLA, Nanning 530021, China

QIN Ming Department of Medical Imaging, 303rd Hospital of PLA, Nanning 530021, China

LI Da-chuang Department of Medical Imaging, 303rd Hospital of PLA, Nanning 530021, China

YANG Jian-jun Department of Pathology, 303rd Hospital of PLA, Nanning 530021, China

*Correspondence to: Huang GX, E-mail: 303hgx@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of Guangxi scientific research and technology development project No. GUIKEGONG1298003-8-6
Received  2015-11-14
Accepted  2015-12-25
DOI: 10.12015/issn.1674-8034.2016.06.009
DOI:10.12015/issn.1674-8034.2016.06.009.

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