Kronik Böbrek Hastalığında Renal Steatozun ve Klinik Evre ile İlişkisinin Kimyasal Şift MRG ile Kantitatif Olarak Değerlendirilmesi

Abstract

Amaç: Kronik böbrek hastalığında renal parankimal lipid birikiminin kantitatif olarak kimyasal şift manyetik rezonans görüntüleme ile ölçülmesi ve klinik evreler ile ilişkisinin değerlendirilmesi amaçlandı

Gereç ve Yöntemler: Bu retrospektif çalışmada gruplar kronik böbrek hastalığı (n=46), kronik böbrek hastalığı olmayan diyabet hastaları (n=31) ve kontrol (n=59) olarak tasarlandı. Kronik böbrek hastalığı grubu kendi içinde diyabetik kronik böbrek hastalığı (n=25) ve non-diyabetik kronik böbrek hastalığı (n=21) olarak iki alt gruba ayrıldı. Yüz otuz altı hastanın toplam 272 böbreği değerlendirildi. Kronik böbrek yetmezliği klinik evrelemesi e-GFR değerlerine göre yapıldı. Tüm manyetik rezonans incelemeleri 1.5 Tesla cihazla yapıldı. Böbrek parankimindeki yağ miktarını ölçmek için, kimyasal şift görüntüleme (Faz içi, faz dışı, Dixon-su ve Dixon-yağ) sekansları kullanıldı. Böbrek ve dalaktan, tüm parankim (Birinci yöntem) ve fokal parankimal (İkinci yöntem) olmak üzere, iki farklı yöntemle ölçümler yapıldı. Yağ fraksiyonu ve dalak-böbrek kimyasal şift görüntüleme oranı hesaplandı.

Bulgular: Birinci ve ikinci ölçüm yöntemlerine göre, kontrol grubunda parankimal yağ fraksiyonu değerleri sırasıyla 0.05±0.01 ve 0.05±0.02 olarak hesaplandı. Kronik böbrek hastalığı gruplarında ise yağ fraksiyonu ölçümleri sırasıyla 0.07±0.02 ve 0.07±0.04 olup, kontrol grubuna göre kronik böbrek hastalığı Evre 3’ten itibaren anlamlı yüksek bulundu (p<0.001). Diyabet hastalarında yağ fraksiyonu ve dalak-böbrek kimyasal şift görüntüleme oranı değerlerinde anlamlı farklılık gözlenmedi (p>0.05).

Sonuç: Kronik böbrek hastalığında renal parankimde evre 3’ten itibaren, kontrol grubu ve diyabetik hastalara göre anlamlı lipid birikimi olmaktadır.

Keywords

• Manyetik rezonans görüntüleme
• kronik böbek hastalığı
• diabetes mellitus

Project Number

YOK

QUANTITATIVE ASSESSMENT OF RENAL STEATOSIS AND ITS RELATIONSHIP WITH CLINICAL STAGE IN CHRONIC RENAL FAILURE USING CHEMICAL SHIFT MRI

Abstract

Objective: Quantitative measurement of renal parenchymal lipid accumulation in chronic renal disease using chemical shift magnetic resonance imaging and evaluation of its relationship with clinical stages.

Material and Methods: In this retrospective study, the groups were designed as in chronic renal disease (n=46), diabetes without chronic renal disease (n=31), and control (n=59). Chronic renal disease group also divided into two subgroups as diabetic chronic renal disease (n=25) and non-diabetic chronic renal disease (n=21). A total of 272 kidneys of 136 patients were evaluated. Chronic renal disease clinical staging was performed according to e-GFR values. All magnetic resonance imaging examinations were performed with a 1.5 Tesla device. Chemical shift imaging was used in this study to quantify fat in the renal parenchyma (in-phase, out-of-phase, Dixon-water and Dixon-fat). Measurements were made from kidney and spleen by two different methods as whole parenchyma (first method) and focal parenchymal (second method). The fat fraction, and spleen-to-renal chemical shift imaging ratio were calculated.

Results: In the control group, parenchymal fat fraction according to first and second measurement methods were calculated as 0.05±0.01 and 0.05 ± 0.02, respectively. In the chronic renal disease groups, fat fraction measurements were 0.07±0.02 and 0.07±0.04, respectively, and they were found to be significantly higher from chronic renal disease stage 3 compared to the control group (p<0.001). No significant difference was observed in fat fraction and spleen-to-renal chemical shift imaging ratio values in diabetes patients (p>0.05).

Conclusion: In chronic renal disease, starting from stage 3, there is a significant renal parenchymal lipid accumulation compared to the control group and diabetic patients.

Keywords

• Magnetic resonance imaging
• chronic renal disease
• diabetes mellitus

Supporting Institution

YOK

Project Number

YOK

Thanks

We are grateful to Uğur Toprak (Professor, Department Radiology, Faculty of Medicine, Osmangazi University, Eskişehir), Ozgur Pirgon (Professor, Department of Pediatric Endocrinology and Diabetes, Faculty of Medicine, S.Demirel University, Isparta), and Murat Korkmaz (Professor, Department of Gastroenterology, Faculty of Medicine, Istinye University, Istanbul) for careful reading of the manuscript and helpful comments and suggestions.

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