移植肾功能延迟恢复的磁敏感加权成像表现与血清胱抑素C的相关性  

Correlation between susceptibility weighted imaging manifestation and serum cystatin C for delayed graft function

作　　者：孙军[1] 邢兆宇[2] 俞胜男[1] 陈杰[1] 查婷婷[1] 范敏[2] 马锦洪[3] 邢伟[1] 

机构地区：[1]苏州大学附属第三医院放射科,常州213001 [2]苏州大学附属第三医院泌尿外科,常州213001 [3]苏州大学附属第三医院检验科,常州213001

出　　处：《中华医学杂志》2016年第21期1682-1686,共5页National Medical Journal of China

基　　金：国家自然科学基金面上项目（81371513）

摘　　要：目的 探讨移植肾功能延迟恢复（DGF）的磁敏感加权成像（SWI）表现与血清胱抑素C水平的相关性.方法 回顾性分析2014年9月至2015年8月苏州大学附属第三医院肾脏移植中心27例DGF的常规MRI、SWI及血清胱抑素C资料.对照DGF移植肾的常规MRI图像,排除囊肿、血管平滑肌脂肪瘤等良性肿瘤在SWI上的影像表现,然后以肾皮质为参照,如在SWI上发现异常信号灶,则对其位置与信号强度进行分析.SWI上未出现与出现异常信号灶DGF组之间的血清胱抑素C水平差异采用独立样本t检验比较,DGF的SWI表现与血清胱抑素C水平之间的相关性采用Spearman等级相关进行分析.结果 15例在SWI上未出现异常信号灶,平均血清胱抑素C水平为（2.92±0.44） mg/L;12例在SWI上于皮髓质交界区出现异常低信号灶,平均血清胱抑素C水平为（6.91±0.96） mg/L;两组DGF之间的血清胱抑素C水平差异有统计学意义（t=-4.040,P=0.000）.DGF在SWI上出现异常低信号灶与血清胱抑素C水平之间呈正相关（r=0.660,P=0.000）.结论 SWI上有无异常信号灶能在一定程度上反映DGF的肾功能受损状况,皮髓质交界区出现异常低信号灶可能预示其肾功能损害程度相对较大.Objective To explore the correlation between susceptibility weighted imaging （SWI） manifestation and serum cystatin C level for delayed graft function （DGF）.Methods The conventional MRI,SWI and serum cystatin C of 27 cases with DGF in nephrotransplantation center in Third Affiliated Hospital of Suzhou University from September 2014 and August 2015 were retrospectively analyzed.By contrasting conventional MRI images of transplanted kidney in DGF,the imaging manifestations of benign tumors such as cysts and angiomyolipomas were excluded on SWI images,and then making the renal cortex as the reference,if the abnormal signal lesions were found in the transplanted kidney,the location and signal intensity would be analyzed.The differences in serum cystatin C level between DGF groups without and with abnormal signal lesions were compared by using independent-sample t-test.The correlation between SWI manifestation and serum cystatin C level for DGF was assessed with Spearman rank correlation analysis.Results A total of 15 cases were found without abnormal signal lesions and the average value of their serum cystatin C level was （2.92 ±0.44） mg/L.A total of 12 cases were found with abnormal low signal lesions located at junctional zone between cortex and medulla,and the average value of their serum cystatin C level was （6.91 ± 0.96） mg/L.The differences in serum cystatin C level between the two DGF groups were statistically significant （t =-4.040,P =0.000）.There was a positive correlation between the abnormal low signal lesions on SWI and serum cystatin C level （r =0.660,P =0.000）.Conclusion The status of renal function impairment could be reflected by being with or without abnormal signal lesions on SWI.A relatively big renal function impairment may be predicted by the appearance of abnormal low signal lesions at junctional zone between cortex and medulla on SWI.

关 键 词：肾移植 移植物功能延迟恢复 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R699.2[医药卫生—诊断学]