肾脏血氧水平依赖MRI的初步应用  

Clinical application of blood oxygenation level-dependent MR imaging of kidney:A preliminary Study

作　　者：徐学勤[1] 李晓[2] 林晓珠[1] 朱晓雷[1] 倪根雄[1] 陈克敏[1] 严福华[1] 方文强[1] 徐耀文[2] 陈楠[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,上海200025 [2]上海交通大学医学院附属瑞金医院肾脏内科,上海200025

出　　处：《诊断学理论与实践》2012年第2期136-140,共5页Journal of Diagnostics Concepts & Practice

基　　金：上海高校选拔培养优秀青年教师科研专项基金(jdy09085);国家自然科学基金(81170671)

摘　　要：目的:探讨肾脏血氧水平依赖(blood oxygenation level-dependent,BOLD)MRI的临床应用价值。方法:对正常志愿者70例(无原发性和继发性肾病病史及肾功能损害危险因素)和57例慢性肾病患者进行GE 1.5THD MRI冠状面BOLD成像,分别测量其肾脏皮质及髓质的自旋弛豫率(R2*)值,并作对比分析。其中10例正常志愿者在1～6个月内进行了相同参数的冠状面BOLD成像检查。结果:T2*图像上,正常肾脏的结构清晰,皮质和髓质分界清,皮质和髓质R2*值分别为(12.63±1.40)/s和(18.14±2.51)/s,双侧肾脏皮质间(t=-1.333,P=0.186)、髓质间(t=0.958,P=0.341)的R2*值差异均无统计学意义。不同年龄及性别的志愿者间肾脏皮质、髓质R2*值亦均无统计学差异(P>0.05)。10例志愿者重复BOLD成像肾脏R2*值无统计学差异。T2*图像上,慢性肾病患者的皮髓质分界不清。正常志愿者与慢性肾病患者间肾髓质R2*值差异有统计学意义(P<0.05)。结论:肾脏BOLD MRI可清晰显示正常肾脏结构,有较好的可重复性,对慢性肾病患者肾髓质缺氧诊断较灵敏,具有较好的科研及临床应用前景。Objective To evaluate the clinical application of blood oxygenation level-dependent（BOLD） MR imaging of kidney.Methods： Seventy healthy volunteers and 57 chronic kidney disease（CKD）patients underwent the BOLD MR imaging of the kidney with a 1.5-T MR imager（GE Signa Excite HD Twin-Speed 1.5T）.R2＊ of cortical and medullar portion of the kidney were calculated and compared.Reproducibility was assessed by repeating the same protocol in 10 randomly selected healthy volunteers after 1-6 months.R2＊ between patients and healthy volunteers were compared.Results： In all healthy volunteers,there was a clear demarcation between cortex and medulla on T2＊ map.Medullary R2＊ were higher than cortical R2＊（18.14±2.51）/s,（12.63±1.40）/s.There was no difference in renal R2＊ between right and left kidney（P〉0.05）,and no difference in renal R2＊ was seen between male and female.There was no correlation of renal R2＊ with age（P〉0.05）.No statistically significant difference was found in repeated studies of healthy volunteers（P〉0.05）.Patients with chronic kidney disease had significantly lower renal medullary R2＊（t=-4.383,P=0.000） than healthy volunteers[（16.35±2.72）/s vs.18.14±2.67）].Conclusions： Demarcation between renal cortex and medulla was clear in BOLD MR imaging of healthy volunteers.It is sensitive to changes of medullary oxygenation,and also is sensitive for the detection of oxygen deficiency in renal medulla of chronic kidney disease patient.It has good prospect to be used in science research and clinical application.

关 键 词：肾脏 血氧水平依赖磁共振成像 自旋弛豫率值 慢性肾病 

分 类 号：R455.2[医药卫生—运动医学]