正常微量白蛋白尿的2型糖尿病患者肾脏磁共振扩散加权成像研究  

Renal MR diffusion weighted imaging in type 2 diabetic patients with normal microalbuminuria

作　　者：肖文霞[1] 陈小燕[1] 李新春[2] 伍筱梅[2] 谭愈昱[1] 何建勋[2] 黄晓淳[1] 

机构地区：[1]广州医学院第一附属医院内分泌科,510120 [2]广州医学院第一附属医院放射科,510120

出　　处：《中华生物医学工程杂志》2011年第6期531-534,共4页Chinese Journal of Biomedical Engineering

基　　金：广东省自然科学基金博士科研启动项目（7301662）;广东省科技厅攻关项目

摘　　要：目的 应用磁共振扩散加权成像（DWI）检测正常微量白蛋白尿（MAU）的2型糖尿病患者肾功能改变,评估其在2型糖尿病患者早期肾损害诊断中的价值.方法 2010年8月至12月在本院内分泌科门诊就诊的MAU在正常范围的2型糖尿病患者10例为观察组,同期健康体检者10例为健康对照组,每组20个肾,两组年龄、性别和体质量指数差异无统计学意义（均P＞0.05）.应用单次激发平面回波DWI和常规MR序列进行双侧肾脏MRI检查,比较两组在弥散敏感梯度系数（b值）分别为400、500、600和800 s/mm2时肾实质表观扩散系数（ADC）,并比较两组血清肌酐和胱抑素C水平.结果 MRI常规序列扫描显示两组肾脏形态、大小及解剖结构无明显差异,血清肌酐及胱抑素C水平差异无统计学意义（均P＞0.05）.DWI检查显示,b值分别为500、600及800 s/mm2时,观察组ADC值分别为（2.15±0.06）×10-3、（2.05 ±0.07）×10-3、（1.87±0.05）×10-3 mm2/s,健康对照组ADC值分别为（2.32±0.07）×10-3、（2.16±0.04）×l0-3、（ 1.95 ±0.04）×10-3 mm2/s,观察组ADC值较健康对照组均显著下降（均P＜0.05）.结论 DWI可能有助于更早期地发现2型糖尿病患者肾功能损害.Objective To investigate the renal function of type 2 diabetic patients with normal microalbuminuria （MAU） by using MR diffusion weighted imaging （DWI）,and to evaluate the role of MRDWI in diagnosis of early renal dysfunction in patients with type 2 diabetes.Methods Ten MAU-normal patients with type 2 diabetes who visited our clinic between August and December 2010 （observation group）and a contemporary cohort of 10 check-up subjects （healthy control group） were enrolled in the study,with 20 kidneys in each group.The two groups were comparable in terms of patient age,gender and body mass index （all P〉0.05）.Single-shot echo planar image DWI and routine MR sequence scan were used to measure bilateral kidneys in these patients or healthy subjects.The apparent diffusion coefficient （ADC） values of the renal parenchyma with diffusion-sensitive gradient coefficient （b value） being 400,500,600 and 800 s/mm2 were compared in two groups,and the serum levels of creatinine and cystatin C were also compared in two groups.Results Between the two groups,routine MR sequence scan did not show any difference in contour,size and anatomical structure of kidney,and the serum levels of creatinine and cystatin C were also similar （both P〉0.05）.By DWI with b values bing 500,600 and 800 s/mm2,the ADC values were respectively （2.15±0.06） × 10-3,（2.05±0.07） × 10-3 and （1.87±0.05） × 10-3 mm2/s in the observation group,compared with （2.32±0.07）×10-3,（2.16±0.04）×10-3 and （1.95±0.04）×10-3 rm2/s in healthy control group.The ADC values were significantly lower in observation group than those in healthy control group （all P〈0.05）.Conclusion DWI may be more useful in identifying early renal dysfunction in patients with type 2 diabetes.

关 键 词：扩散加权成像 糖尿病肾病 早期诊断 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]