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Localized 31 P MR spectroscopy of the transplanted human kidney in situ shows altered metabolism in rejection and acute tubular necrosis
Author(s) -
Heindel Walter,
Kugel Harald,
Wenzel Folker,
Stippel Dirk,
Schmidt Rainer,
Lackner Klaus
Publication year - 1997
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.1880070514
Subject(s) - necrosis , acute tubular necrosis , transplantation , in vivo , nuclear magnetic resonance spectroscopy , in vivo magnetic resonance spectroscopy , chemistry , medicine , kidney , pathology , magnetic resonance imaging , biology , radiology , microbiology and biotechnology , organic chemistry
The purpose of this study was to investigate the function of transplant kidneys in situ, and to detect pathologic changes, using volume‐selective phosphorous NMR spectroscopy ( 31 P MRS). Localized 31 P MR spectra were obtained from 37 patients using a whole‐body MR scanner with a combination of surface coils, adiabatic excitation pulses, and a modified image‐selected in vivo spectroscopy (ISIS) sequence. Seventeen patients with pathologic changes after renal transplant were compared with a control group of 20 patients with no evidence of transplant dysfunction. The transplant kidneys with rejection reaction showed higher ratios of inorganic phosphate (P i ) to adenosine triphosphate‐α (ATP‐α) than the normal control group (.4 ± .16 compared with .22 ± .11, P = .01) and reduced pH. The spectra of transplant kidneys with tubular necrosis had lower phosphomonoester (PME)/phosphodiester (PDE) ratios than the control group (.65 ± .35 compared with .96 ± .5, P = .04). The pathologies of rejection and tubular necrosis could be differentiated from each other by pH (6.93 ± .1 in rejection versus 7.14 ± .19 in tubular necrosis, P = .04). Preliminary results indicate that localized image‐guided 31 P MR spectroscopy of transplant kidneys in situ can detect rejection reactions and acute tubular necrosis noninvasively, providing an incentive for further research.