用于预测脏全移植功能的下降:与临床参数进行比较
Wei Wang1,2, Yuanmeng Yu3,4, Jinsong Chen5
1National Clinical Research Center of Kidney Diseases, Jinling Clinical Medical College of Nanjing Medical University, Nanjing, 210002, Jiangsu, China.
Insights into imaging
|February 15, 2024
概括
扩散加权成像 (DWI) 参数,特别是皮质D和 perfusion fraction (fp),在与临床因素相结合时,显著提高预测长期代移植功能的下降. 这种方法为移植接受者提供了更好的预后价值.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 放射学 放射学是一门学科.
- 移植医学 移植医学 移植医学
背景情况:
- 合移植功能下降是移植受体的一个重大问题.
- 预测长期的全移植功能对于患者管理至关重要.
- 扩散权重成像 (DWI) 显示了对移植的非侵入性评估的潜力.
研究的目的:
- 评估扩散权重成像 (DWI) 对临床参数的附加益处,以预测移植异位功能下降.
- 评估包含临床和DWI参数的不同模型的预测能力.
- 为了确定特定的DWI衍生参数的预后值,用于长期的全移植结果.
主要方法:
- 追溯分析了97名接受过酒后驾驶的移植患者的数据.
- 使用单指数和双指数模型对DWI信号进行分析,以导出诸如明显扩散系数 (ADCT),真扩散 (D),伪扩散 (D*) 和 perfusion 分数 (fp) 等参数.
- 三种预测模型的构建和比较:仅临床参数,仅DWI参数,以及使用接收器操作特征曲线 (AUROC) 下面面积的组合模型.
主要成果:
- 45名患者在98个月的中位随访期内经历了移植功能下降.
- 结合临床和DWI参数的组合模型 (模型3) 在60个月和84个月时显示出明显高于临床模型 (模型1) 的AUROC.
- 多变量分析确定了基线eGFR,蛋白尿,皮质D和皮质FP作为长期全移植功能下降的显著预测因素.
结论:
- 扩散加权成像 (DWI) 参数,特别是皮质D和fp,为预测长期脏全移植功能下降提供了额外的预后价值.
- 将DWI衍生参数 (皮质D和fp) 与基线临床因素 (eGFR和蛋白尿) 整合起来,与单独的临床参数相比,可以提高预测准确度.
- 多种b DWI显示为管理脏移植接受者和监测全移植健康的承诺.
相关概念视频
Assessment of Diffusion and Perfusion
Understanding and evaluating diffusion and perfusion is critical in assessing a patient's respiratory and circulatory health. These processes play key roles in maintaining the body's internal environment, ensuring that tissues receive adequate oxygen while waste products are efficiently removed.
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
Imaging Studies I: Kidney, Ureter, and Bladder Studies
Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
Acute Kidney Injury I: Introduction
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...


