前瞻性人体移植肾急性排斥BOLD与DW早期诊断价值  

Value of BOLD and DWI Technology in Transplanted Renals with Early Acute Rejection: A Perspective Experience on Human

作　　者：黄桂雄[1] 黄海波[1] 李大创[1] 孙旭勇 管俊[1] 曹理政 杨建均[3] 

机构地区：[1]解放军第303医院医学影像科,广西南宁530021 [2]解放军第303医院移植科,广西南宁530021 [3]解放军第303医院病理科,广西南宁530021

出　　处：《中国CT和MRI杂志》2016年第2期84-88,共5页Chinese Journal of CT and MRI

基　　金：广西科学研究与技术开发计划项目(桂科攻1298003-8-6)

摘　　要：目的探讨BOLD_R2*与DWI_ADC值人体肾移植急性排斥早期诊断价值。方法随机选取正常原位肾33例(A组)、正常移植肾34例(B组)、急性排斥移植肾15例(C组)为研究对象,应用3.0T扫描仪BOLD及DWI序列扫描所有志愿者,将图像输至工作站分析处理。比较三组肾皮质、髓质R2*及与肌肉标准化ADC0-100、ADC0-800值差异性,P<0.05为有统计学差异。以病理为"金标准",评价髓质R2*及与肌肉标准化皮质ADC0-100、ADC0-800值鉴别急性排斥移植肾与移植正常肾、正常原位肾诊断效能。结果 (1)三组间肾髓质R2*差异有统计学意义,两两比较发现C组R2*明显低于与A、B组,A与B组间无统计学差异;三组间肾皮质R2*差异无统计学意义。以病理为标准,髓质R2*=22.7hz为界值,BOLD_R2*区别急性排斥与移植正常肾、原位正常肾ROC曲线下面积为0.981,SE和SP分别为93.3%和100%。(2)三组间肾皮质标准化ADC0-100、ADC0-800值有统计学意义,两两比较除A与B组间差异无统计学意义外其余组间有统计学意义。三组间髓质ADC0-100、ADC0-800值无统计学意义。以病理为标准,取1.249、1.122为界值,标准化皮质ADC0-100、ADC0-800诊断急性排斥移植肾ROC曲线下面积分别为0.947、0.978,SE、SP分别为83.3%、86.7%,91.1%、92.3%。结论 BOLD与DWI在肾移植急性排斥早期诊断中有重要价值,可为后期治疗提供可靠影像依据。Objective To perspectively investigate the value of BOLD_R,＂ and I）WIADC in monitoring human renals with early acute rejection. Methods 33 cases of healthy kidneys in situ （group A）, 34 cases of normal renal allograft （group B） and 15 cases of renals with acute rejection （group C） who underwent BOLl） and DWI procedure at 3.0T were selected as tile research objects. The clatas were transfered into the workstation for processing after MP.I. The measurements of P.. and A1）C AI）C standardized with muscle on renal crtex, medulla were obtained among the three gToups, P〈0.05 was diflbrence significant. According to the patlmlogica[ biopsy, the values of BOLD and DWI_ADC standardized to differencitae the kidneys with acute rejection were assessed by ROC）curve. There were statistic significance for on renal medulla among the three groups（P〈0.05）, however no statistic significances were found for medullary R2＇ between group A and B; While no statistic significances were fimnd fnr cortical R2＂ among the three groups（P〉0.115）. With an area under the ROC curve of R2=22.7hz as diagnose critical points, the sensibility was 93.3%, the specificity was 100%, and the accuracy was 0.981 in the prediction of the kidneys with acute rejection. There were statistic significance for cortical standardized ADC ADC within groups（P〈ll.05）, however no statistic significances were found t＇or cortical standardized ADC. =0-100 ADC between group A and B; while no statistic significances were found for medullary standardized ADC0-800, ADC among three groups（P〉0.05）, With an area under the P.OC curve of ADC. = 1.240, ADC, R2= 1.122 as diagnose critical points, the sensibili was 83.3% and 86.7%, the specificity was q1.1% and 92.3%, and the accuracy was 0.947 and （1.978 in the prediction of the transplanted renals with acute rqection, respectively.BC）LI） and DWI is of important value in the early diabmosis of renal acute rejection, which can provide reliable imaging evidence for later trea

关 键 词：移植肾 急性排斥 血氧水平依赖成像 扩散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]