MR弥散加权成像评估大鼠缺血性肾脏结构及功能损伤的实验研究  

Experimental study on DWI in identifying ischemic renal impairment and dysfunction in rats

作　　者：杨朝武[1] 何光武[1] 赵炳辉[2] YANG Chao-wu HE Guang-wu ZHAO Bing-hui(Department of Radiology, Baoshan Branch of Shanghai First People＇s Hospital, Shanghai 200940, China Department of Radiology, Shanghai Tenth People＇s Hospital, Shanghai 200072, China)

机构地区：[1]上海市第一人民医院宝山分院放射科,上海200940 [2]上海市第十人民医院放射科,上海200072

出　　处：《磁共振成像》2017年第3期223-227,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：上海市宝山区卫生青年医学人才培养计划项目(编号:bswsyq-2016a05)~~

摘　　要：目的与SPECT肾功能成像及病理学、MRI平扫及增强检査对照,探讨MR弥散加权成像(diffusion weighted imaging,DWI)评估大鼠缺血性肾脏结构及功能损伤的价值。材料与方法选取24只雄性SD大鼠制作左侧肾动脉狭窄摸型,分別行双肾^(99)Tc^m-DTPA肾显像测量肾小球滤过率(giomendar filtration rate,GFR)及3.0 T磁共振DWI、T1WI、T2WI及MRI增强检查并进行图像分析。DWI的b值分别采用0、800、1000、1200、1500 s/mm^2扫描,并测量表观弥散系数值(apparent diffusion coefficient,ADC),分别测量三次取平均值,比较双侧肾脏实质ADC值差异,分析ADC值与SPECT肾显像GFR相关性。统计学方法分別采用配对样本t检验及非参数相关分析。结果肾实质(ROI包括皮、髓质)ADC值与GFR呈正相关(F=0.001、r=0.584);双肾皮质ADC值比较t=4.626,F=0.001;双肾髓质ADC值比较t=2.699,P=0.019,均有明显差异性。DWI可显示肾脏局灶性缺血损伤及重度缺血损伤肾萎縮。结论MR DWI作为肾脏的无创影像学检查方法、对评估肾功能及结构损伤有一定价值,有助于中晚期肾损伤评估,对喊少潜在对比剂肾损伤有较大价值。Objective： To investigate diffusion weighted imaging（DWI） in evaluating renal impairment and dysfunction in rats due to unilateral renal arterial stenosis（RAS）, contrast to 99Tcm-DTPA SPECT Renograhy and pathology. Materials and Methods： The model of the unilateral left RAS was created in twenty-four rats according to the approved protocol. The renal impairment and dysfunction were subsequently measured by 99 TcmDTPA SPECT based on the glomerular filtration rate（GFR）, DWI based on the apparent diffusion coefficient（ADC） value after two, three and four weeks. The b value of DWI was scanned under the 0 s/mm2, 800 s/mm2, 1200 s/mm2 and 1500 s/mm2 respectively. As well the average values of ADC of the renal medulla and cortex parenchyma were calculated respectively and compared. The relationship between GFR and the imaging based on 99 TcmDTPA SPECT were detected. The Spearman＇s correlation test and the paired-samples t test were adopted in statistics. Results： The values of ADC of renal parenchyma（ROI including medulla and cortex） had a significant positive correlation with GFR（P=0.001, r=0.584）. The values of ADC of the cortical and medulla were significant different between the two kidneys（cortex： t=4.626, P=0.001; medulla： t=2.699, P=0.019）. Conclusions： The DWI based on ADC is significant to evaluate the renal impairment and dysfunction, which is helpful to detect the late period of renal ischemic injury and reduce the renal injury caused by contrast agent.

关 键 词：缺血性肾损伤 肾功能不全 磁共振成像 弥散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R692[医药卫生—诊断学]