Comparison Of DCE-MRI Renography,SPECT Renography And Endogenous Creatinine Clearance Rate In Kidney Transplant Reciepients

Objective To investigate the accuracy of dynamic contrast-enhanced magnetic resonance(DCE-MRI)and SPECT in the measurement of glomerular filtration rate(GFR)in renal allograft.Methods Sixty renal transplant recipients were enrolled in this study.DCE-MRI and SPECT were used to measure the GFR of the transplanted kidneys,and compared with the endogenous Creatinine Clearance Rate(Ccr).Bias,precision,correlation and Bland-Altman agreement analysis were calculated for each modality compared with CCr.Results In 60 renal transplant recipients,the corrected Ccr was(60.63±24.83)ml/min/1.73m2.The GFR measured by SPECT was(65.31±17.08)ml/min/1.73m2,and by MRI was(50.44±22.78)ml/min/1.73m2.The bias of GFR-SPECT was 4.69 ml/min/1.73m2,and the precision was 23.76 ml/min/1.73m2.The bias of GFR-MRI was-10.18 ml/min/1.73m2,and the precision was 13.87 ml/min/1.73m2.Correlation analysis showed that GFR-MRI and Ccr had well correlation(r=0.833,P<0.01),linear regression equation was Ccr=22.298+0.833*GFR(MRI),n=60;GFR-SPECT and Ccr had maderate correlation(r=0.406,P<0.01),linear regression equation was Ccr=34.169+0.406*GFR(SPECT),n=60;GFR-MRI and GFR-SPECT had poor correlation(r=0.342,P<0.01),linear regression equation was GFR(SPECT)=16.192+0.342*GFR(MRI),n=60.Bland-Altman analysis showed a confidence interval of 95.3 ml/min/1.73m2 for GFR-SPECT and 62.3 ml/min/1.73m2 for GFR-MRI.Conclusion DCE-MRI can be used as confidently as SPECT to evaluate the renal function of transplanted kidney in the same time of determining anatomical information.