Application of time-spatial labeling inversion pulse in renal corticomedullary differentiation and time parameter optimization / 中国医学影像技术

Objective To investigate the application value of time-spatial labeling inversion pulse (T-SLIP) in renal corticomedullary differentiaton and the best black blood inversion time (BBTI) value.Methods Totally 60 volunteers were included,who underwent abdominal MR scan with noncontrast-enhanced SSFP sequence combined with T-SLIP.All subjects were scanned with different BBTI (800,1 000,1 200,1 400,1 600,1 800 ms) using coronary T-SLIP SSFP sequence.The images quality was evaluated using a four-point scale method.The region of renal cortex and medulla was devised automatically based on the image training algorithm.The signal intensity ratio with the different BBTI was calculated through measuring the signal intensity of the renal cortex and medulla.And the best BBTI values were analyzed.Results When BBTI was 1 200 ms,the image score was the highest.The signal intensity ratio (SIR) had statistical difference among different BBTI groups (all P＜0.05),when BBTI was 1 200 ms,the SIR was the highest,and the contrast between the renal cortex and medulla was obvious.Conclusion T-SLIP technology can improve the visibility of renal corticomedullary without contrast agents.The optimal BBTI for the best corticomedullary differentiation is 1 200 ms.

Assessment of the diffusion-weighted imaging for the pathology and renal function in IgA nephropathy / 天津医药

Objective To study the correlation between the diffusion-weighted imaging (DWI) measurements and glomerular filtration rate (GFR), Katafuchi scores in IgA nephropathy. Methods Thirty-five patients with IgA nephropathy (IgAN group) and twenty healthy volunteers (control group) were enrolled in this study. All of the subjects underwent bilateral renal DWI measurements with 3.0T MRI scanner. The values of apparent diffusion coefficient (ADC) of renal cortex and medulla were measured. GFR of IgAN group was detected with 99Tcm-DTPA scintigraphy. Based on the Lee classification and the Katafuchi score system, the pathological grading was carried out in patients of IgAN group. The ADC values were compared between control group and different grades of IgAN group. The correlations between ADC and GFR values were analysed in defferent groups. The correlations between ADC values and Katafuchi scores were analysed in IgAN group. Results The renal cortical ADC values were significantly higher than medulla ADC values in both control group and IgAN group (P 0.05). There was a positive correlation between the renal cortical and medulla ADC values and the GFR values in IgAN group (P medulla ADC values and the Katafuchi scores in IgAN group (P<0.05). Conclusion The diffusion-weighted imaging can reflect the physiological functions of kidney. It was feasible for application DWI in IgA nephropathy, which can be used for assessing the renal filtration function and the pathological damage. However, DWI measurement is not sensitive to early renal disease.

Blood Oxygen Level Dependent MRI of Normal Kidney and Its Correlation with Physiological Indexes / 天津医药

Objective To explore the characteristics of blood oxygen level dependent (BOLD) magnetic resonance imaging (MRI) in healthy native kidneys. To investigate the relationship between BOLD-MRI and common physiological in-dexes. Methods GE 3.0T MRI scanner and Torsopa phased-array coil were employed to acquire renal coronal T1WI and BOLD image. Ninety patients who were ruled out chronic kidney diseases underwent BOLD-MRI with T2*-spoiled gradient recalled echo (T2*SPGR) sequence. BOLD images were analyzed on R2*map software. Cortical and medullary R2*values were analyzed in bilateral kidneys and in different gender. Different regional R2*values in cortex and medulla were also ana-lyzed. Physiological indices including age, body height and weight, body mass index (BMI), body surface area (BSA), estimat-ed glomerular filtration rate (eGFR) were recorded. Correlation between R2*value and physiological indices were analyzed. Results Bilateral renal cortical R2*values [left (16.56±1.40) Hz and right (16.66±1.28)Hz, respectively] were less than val-ues in medulla [left (28.82±3.71)Hz and right (28.36±3.72)Hz, respectively]. Female and male cortical R2*values [female (16.55±1.30Hz) and male (16.66±1.38)Hz, respectively] were also less than corresponding values in medulla [female (28.46± 3.64) Hz and male (28.70±3.78) Hz, respectively]. In bilateral renal medullary region, R2*values in low pole (27.29±3.05) Hz was less than values in middle (29.32±3.47) Hz and upper pole (29.16±4.21)Hz (F=15.184, P<0.001). Age was positive-ly correlated with R2* values in medulla (r =0.284, P =0.002). However, eGFR was negatively correlated with medullary R2*value (r=-0.232, P=0.007). Conclusion R2*values reflected the levels of renal partial pressure of oxygen and as-sessed the degree of renal ischemia. BOLD MRI could offer a simple, convenient and noninvasive method for to evaluate renal oxygen metabolism in cortex and medulla.

The 64-MSCT study of relationship between renal corticomedullary differentiation, contrast between renal cortex and medulla, renal cortex and medulla CT peak value with the single renal function in hydronephrotic kidney / 中华放射学杂志

valuating the unilateral renal function of hydronephresis.

Electron microscopic observation of Randall's plaque in patients with calcium oxalate stone / 中华泌尿外科杂志

Objective To study the ultrastructure of the renal papillary Randall's plaque in calclum oxalate stone formers. Methods The 14 biopsy samples of the Randall's plaque in 12 patients with calcium oxalate stone undergoing PCNL for stone removal were obtained using endoscopic biopsy technique,followed by staining with hematoxylin-eosin or fixing with osmium tetroxide,and then the ultrastructure of the Randall's plaque was observed under light microscope and transmission electron microscope. Results In all 12 patients,72 renal papillae were examined.All kidReys were found to have papillary plaque and 7 of the patients had attached stones.Sixty-three papillae(87.5%)contained plaque.Calcium deposition was seen in the 12 renal papilla tissue by light microscopy.Transmission electron microscopy images of the 2 Randall's plaque samples showed several cluster of sharp and large crystals lied closer to the surface of Randall's plaque.The typical crystals were acicular with light profile. Conclusions Randall's plaque is an interstitial medullary and papillary deposit of calcium oxalate.The appearance of the deposition of calcium oxalate crystals lies upon Randall's plaque,which might be an explanation for the mechanism of calcium oxalate stone formation.

Developmental variation of renal apparent diffusion coefficient in rat / 中华放射学杂志

Objective To analyze the changes of renal apparent diffusion coefficient(ADC)value during development in intact rats.Methods Five intact male Wistar rats(1 month of age)were involved in this study.Using SE-echo planar imaging(EPI)sequence to acquire renal DWI at a 3.0 T MR on day 1,day 5,day 10,day 30,and day 50,respectively.The b value was 0 and 500 s/mm2.The ADCs of the cortex and the medulla were measured on the right kidney and the renal volume was calculated by manually renal outling on each slice.The difference of ADC between the cortex and the medulla was analyzed using a paired student t test,and the changes of renal volume and ADCs with rats development were evaluated with a repeated measurement ANOVA.Results The ADC of the cortex was higher than that of the medulla except on day 1(P＜0.01).when b value 0 and 500 s/mm2 were chosen.Renal volume increased with the rat development.from(0.86±0.02)ml to(1.47±0.21)ml.And the ADCs of both the cortex and medulla increased from(1.66±0.14)×10-3mm2/s to(1.96±0.08)×10-3mm2/s for the cortex and from (1.54±0.12)×10-3mm2/s to(1.91±0.09)×10-3mm2/s for the medulla.Conclusion Renal ADCs of both the cortex and medulla increase during the period from 1 to about 3 months of age in rats.The influence of age on renal ADC should be considered when choosing rats aged from 1 to 3 months for MR study.

Reproducibility of measuring renal oxygenation by blood oxygen level-dependent MRI in rat / 中华放射学杂志

Objective To evaluate the reproducibility of measuring renal oxygenation in rat using blood oxygen level-dependent MR imaging(BOLD MRI).Methods Five intact male Wistar rats were included in this study and their body weights were measured before MRI scans.BOLD MRI were performed ou day 1(d1),day 5(d5),day 10(d10),day 30(d30)and day 50(d50)on a 3.0 T MR scanner to measure the apparent spin-spin relaxation(R2*).On d30 and d50,the differences of R2*(△R2*)were calculated between before and 10 min after furosemide injection through the tail vein.The reproducibility of the baseline R2* of 5 times repeated scans were verified by the repeated-measure ANOVA test.The R2* and △R2* between pre-and post-furosemide iniection on d30 and d50 were measured on the codex and the medulla and a paired t test was run to analyze their responses to furosemide and the reproducibility of △R2*.Results The average body weight on d1,d5,d10,d3 and d50 was(150.4±3.7)g、(170.2±7.0)g、(201.0±5.8)g、(306.2±17.0)g and(352.0±12.2)g,respectively,with statistical difference(F=422.103.P＜0.01).The R2* showed no statistical difference in the cortex and medulla among the five scans(P＞0.05).On d30.the R2* of the cortex and medulla was(25.2±1.2)and(32.8±2.2)Hz before and significantly decreased to(21.1±2.2)and(25.9±3.0)Hz after furosemide administration,respectively(P＜0.01).On d50,the R2* of the cortex and medulla was(25.9±0.8)and(34.3±3.9)Hz before and significantly decreased to(20.2±1.5)and(27.0±3.2)Hz after furosemide administration.respectively(P＜0.01).The △R2* on the codex and medulla was(4.1±1.7)and(6.9 4-2.8)Hz on d30 and(5.8±1.1)and(7.3±2.8)Hz on d50,respectively,but there is no significant difference between eortex and medulla(P＞0.05).Conclusion The baseline R2* in the cortex and medulla were reproducible over 50 days and they were not body weighted.On 3.0 T MR scanners.R2* in the codex and medulla decreased significantly after administration of furosemide.

Clinicopathological manifestations of nephronophthisis-medullary cystic kidney disease / 中华肾脏病杂志

Objective To report the clinicopathological features of 2 cases of nephronophthisis-medullary cystic kidney disease (NPH-MCKD). Methods The clinical data and pathological changes of renal biopsy in two patients of NPH-MCKD from our hospital were analyzed, and associated literatures were reviewed simultanously. The clinicopathological featuresand diagnosis of NPH-MCKD were discussed. Results Two adolescent patients were admitted to our hospital for indolent renal insufficiency, polyuria accompanied by polydipsia as first signs.Urine analysis showed low specific density urine, mild proteinuria, and few formed elements in urinary sediments. The ability of urine concentration and acidification was decreased. Familial history of renal disease and extra-renal lesions were not found. Renal ultrasound presented an increased echogenicity with diminished cortico-meduUary differentiation, and multiple small cysts in renal corticomedullary border were identified in one case by computed tomography. Pathological examination of renal biopsy revealed diffuse tubular interstitial lesion which was characterized by the triad of tubular basement disintegration, tubular atrophy with cyst development, and interstitial fibrosis. Some of glomerular sclerosis occurred. Cyst development at the corticomedullary border of the kidneys was the specific feature of NPH-MCKD. Conclusions Young patients with impaired tubular function should be suspected of NPH-MCKD. Renal ultrasound or computed tomography can provide an important clue. Multiple renal cysts at the corticomedullary border identified by renal biopsy can be a diagnostic indication for NPH-MCKD.

Characteristic of chromogranin A,synaptophysin and neuron-specific enolase in cortex and medulla of adrenal / 中国医师杂志

Objective To study the characteristic of chromogranin A(CgA),synaptophysin(SYN) and neuron-specific enolase(NSE) in cortex and medulla of adrenal.Methods Immunohistochemical method was used to detect the expression of CgA,SYN and NSE in routinely processed tissue specimens from human adrenal neoplasm and hyperplasia.Results The expression of CgA was detected in cortex of adrenocortical adenoma,adrenal neoplasm and chromophile tumor,but not in that of hyperplasia and normal adrenal.The expression of NSE was detected in cortex of adrenal cortical hyperplasia,cortical adenomas and pheochromocyte carcinoma,but not in that of pheochromocytoma and normal adrenal.The expression of SYN was detected in cortex of corticohyperplassia,cortical adenomas,medull neoplasm,chromophile tumor and pheochromocyte carcinoma,but not in that of cortical adenocarcinoma and normal adrenal.The expressions of CgA,NSE and SYN were detected in the medulla of all cases.Conclusion The characteristic of CgA,SYN and NSE in cortex and medulla of adrenal are useful in the differential diagnosis of tumor and hyperplasia in the adrenal.The relationship between the adrenal cortex and medulla is close.Besides the classical hypothalamus-pituitary-adrenal axis(HPAA) and rennin-angiotensin-aldosterone system(RAAS),the adrenal cortex and medulla have the basis of anatomy and endocrinology.