Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Evaluation of Cerebral Blood Flow Using Arterial Spin Labeling in Patients with Chronic Kidney Disease

만성 콩팥병 환자들에서 동맥 스핀 표지 기법을 이용한 뇌 관류상태의 평가

  • Se Won Oh (Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Samel Park (Department of Internal Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Nam-jun Cho (Department of Internal Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Hyo-Wook Gil (Department of Internal Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Eun Young Lee (Department of Internal Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Hyung Geun Oh (LEE & OH Neurology Clinic) ;
  • Sung-Tae Park (Department of Radiology, Soonchunhyang University Seoul Hospital)
  • 오세원 (가톨릭대학교 의과대학 은평성모병원 영상의학과) ;
  • 박삼엘 (순천향대학교 천안병원 신장내과) ;
  • 조남준 (순천향대학교 천안병원 신장내과) ;
  • 길효욱 (순천향대학교 천안병원 신장내과) ;
  • 이은영 (순천향대학교 천안병원 신장내과) ;
  • 오형근 (이앤오 신경과) ;
  • 박성태 (순천향대학교 서울병원 영상의학과)
  • Received : 2020.04.30
  • Accepted : 2020.05.16
  • Published : 2020.07.01
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Abstract

Purpose This study aimed to compare the brain perfusion status of patients with chronic kidney disease to a normal control group to identify any significant differences. Materials and Methods The perfusion state of the brain was measured by MRI using the arterial spin labeling technique in 36 patients undergoing hemodialysis due to chronic kidney disease and 36 normal controls. Images were then analyzed in a voxel-wise manner to detect brain areas showing significant perfusion differences between the two groups. Results Patients with chronic kidney disease showed increased perfusion in the form of large clusters across the right fronto-parieto-temporal lobe and the left parieto-occipital lobe. In addition, perfusion increased in the bilateral thalami, midbrain, pons, and cerebellum (p < 0.01, familywise error corrected). Conclusion Brain perfusion appears to increase in patients with chronic kidney disease compared to normal controls. Uremic toxicity is thought to be the cause of this increase as it can cause damage to the microscopic blood vessels and their surrounding structures.

목적 만성 콩팥병 환자에서 뇌 관류상태를 측정하여 정상 대조군과 차이가 있는지 알아보고자 하였다. 대상과 방법 만성 콩팥병으로 혈액 투석을 받는 환자 36명과 정상 대조군 36명에 대해 동맥스핀 표지 기법을 이용한 자기공명영상으로 뇌의 관류상태를 측정한 뒤 이를 voxel-wise로 분석하여 유의한 차이를 보이는 부위를 표준 영상 공간에 나타냈다. 결과 만성 콩팥병 환자들은 우측 전두엽, 두정엽, 측두엽과 좌측 두정엽과 후두엽의 백질 부위에 걸쳐 큰 군집의 형태로 관류 증가가 나타났다. 또한 양측 시상 부위와 중뇌, 뇌교 및 양측 소뇌에서도 관류 증가 소견을 보였다(p < 0.01, family-wise error corrected). 결론 만성 콩팥병 환자에서 뇌의 관류는 증가되어 있는 것으로 생각되며 이는 요독증 물질의 독성에 의한 미시적인 혈관 및 혈관 주위 구조물의 손상에 의한 것으로 생각된다.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea funded by the Ministry of Science and ICT (NRF-2017R1C1B5018379).

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