Could MRI Be Used To Image Kidney Fibrosis? A Review of Recent Advances and Remaining Barriers

Clinical journal of the American Society of Nephrology: CJASN

General Leung¹  Anish Kirpalani¹  Stephen G. Szeto² 

[1] *Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital,..;*Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital,..*Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital,..§Department of Radiation Oncology, and..‖Department of Mechanical and Industrial Engineering and Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada..*Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital,..

关键词: chronic kidney disease;    MRI;    microvascular injury;    stiffness;    elastography;    biopsy;    cicatrix;    fibrosis;    kidney;    magnetic resonance imaging;    renal insufficiency;    chronic;    selection bias;   

DOI  :  10.2215/CJN.07900716

学科分类：泌尿医学

来源: American Society of Nephrology

【 摘 要 】

A key contributor to the progression of nearly all forms of CKD is fibrosis, a largely irreversible process that drives further kidney injury. Despite its importance, clinicians currently have no means of noninvasively assessing renal scar, and thus have historically relied on percutaneous renal biopsy to assess fibrotic burden. Although helpful in the initial diagnostic assessment, renal biopsy remains an imperfect test for fibrosis measurement, limited not only by its invasiveness, but also, because of the small amounts of tissue analyzed, its susceptibility to sampling bias. These concerns have limited not only the prognostic utility of biopsy analysis and its ability to guide therapeutic decisions, but also the clinical translation of experimental antifibrotic agents. Recent advances in imaging technology have raised the exciting possibility of magnetic resonance imaging (MRI)–based renal scar analysis, by capitalizing on the differing physical features of fibrotic and nonfibrotic tissue. In this review, we describe two key fibrosis-induced pathologic changes (capillary loss and kidney stiffening) that can be imaged by MRI techniques, and the potential for these new MRI-based technologies to noninvasively image renal scar.

【 授权许可】

CC BY