肾脏ADC值与糖尿病肾病的相关性分析:单中心前瞻性研究  

Correlation Analysis of Renal ADC Value and Diabetic Nephropathy:A Prospective Single Center Study

作　　者：章娜[1] 彭茜[1] 黄晓佳[1] 牛翔科 严宗逊[1] Zhang Na Peng Xi Huang Xiaojia et al(Affiliated Hospital of North Sichuan Medical College, Nanchong , Sichuan 637000, Chin)

机构地区：[1]川北医学院附属医院内分泌科,四川南充637000 [2]成都大学附属医院放射科,四川成都610000

出　　处：《四川医学》2017年第4期401-404,共4页Sichuan Medical Journal

摘　　要：目的探索扩散加权成像衍生参数ADC值与糖尿病肾病不同分期之间的关系,并分析ADC值在区分糖尿病肾病不同分期中的价值。方法 2014年2月至2016年8月,前瞻性纳入临床确诊的156名糖尿病肾病患者作为试验组,门诊纳入34名健康体检者作为对照组。入组均接受3.0T磁共振扫描,扩张加权成像b值选择0和600 s/mm^2,后处理工作站测量肾皮质ADC值。试验组根据肾小球滤过率分为3组,单因素方差分析肾小球滤过率在各组之间的差异,肾小球滤过率与肾脏ADC值之间的关系采用pearson相关性分析,采用ROC曲线分析ADC值在区别各组之间的价值。结果肾皮质平均ADC值在各组之间差异均有统计学意义(P<0.05);平均ADC值与糖尿病肾病临床分期之间存在负相关关系(r=-0.720,P<0.001),与肾小球滤过率之间呈正相关关系(r=0.658,P<0.001)。平均ADC值在区别1组与对照组、1组与2组、2组与3组的曲线下面积分别为:0.693,0.801,0.824。结论肾皮质ADC值与糖尿病肾病肾脏功能之间存在正相关关系,其无创性及无需注入对比剂的特点可使其成为糖尿病患者检测及随访肾脏功能的有效手段。Objective To investigate the relationship between ADC value of diffusion weighted imaging parameters and different stages of diabetic nephropathy,and to analyze the value of ADC value in distinguishing different stages of diabetic nephropathy. Methods 156 patients with diabetic nephropathy in the hospital from February 2014 to August 2016 were enrolled in this study. And 34 healthy outpatients were enrolled as control group. In both experimental and control group,3. 0T magnetic resonance imaging was performed,and the expansion-weighted imaging b value was chosen to be 0 and 600 s/mm^2. The post-processing workstation measured the renal cortex ADC value. The experimental group was divided into 3 groups according to the glomerular filtration rate. One-way analysis of variance was conducted to analyze the difference of glomerular filtration rate in the 3 groups. And the relationship between glomerular filtration rate and renal ADC value was analyzed by Pearson correlation analysis. The ROC curve was used to analyze the distinguishing value of ADC value among the groups. Results There was a significant difference in the mean ADC values of the groups. A negative correlation existed between clinical stage of diabetic nephropathy and the mean renal ADC value（ r =-0. 720,P〈0. 001）. And a positive correlation was found between the mean ADC and glomerular filtration rate（ r=0. 658,P〈0. 001）. And the area under the ROC curve of the mean ADC values in distinguishing group 1 and the control group,group 1 and group 2,group 2 and group 3 were 0. 693,0. 801 and 0. 824 respectively. Conclusion There was a positive correlation between the ADC value of renal cortex and the renal function of diabetic nephropathy. The noninvasive and non-contrast agent needed characteristic might make ADC value an effective method for detecting and monitoring kidney function in patients with diabetes.

关 键 词：糖尿病肾病 弥散加权成像 磁共振成像 表观弥散系数 

分 类 号：R587.2[医药卫生—内分泌]