T2＊校正水脂分离MRI评价慢性肾脏病非透析患者骨髓脂肪含量变化  

Changes in marrow fat content of non-dialysis chronic kidney disease patients assessed by Tz ~ -corrected water-fat MRI

作　　者：刘彪[1] 罗汉传[1] 李雪萍[1] 黄波[1] 林东源[2] 

机构地区：[1]贵港市人民医院放射科,广西贵港537100 [2]贵港市人民医院肾内科,广西贵港537100

出　　处：《实用放射学杂志》2017年第6期599-602,共4页Journal of Practical Radiology

摘　　要：目的 探讨T2＊校正水脂分离序列定量慢性肾脏病（CKD）非透析患者腰椎骨髓脂肪分数（MFF）及其与骨代谢指标的相关性。 方法 78例CKD患者按肾小球滤过率（eGFR）分为5组，所有患者行T2＊校正3D VIBE水脂分离扫描，计算MFF并评价2次重复扫描的精确性及不同观察者测量MFF的一致性。检测血钙、磷、碱性磷酸酶、骨钙素、甲状旁腺素及25（OH）D3。 结果 MRI重复扫描MFF变异系数为2.37%，观察者间测定MFF组内相关系数（ICC）为0.901，2位观察者内ICC分别为0.959、0.948。MFF在各期CKD中均存在统计学差异，与血钙、磷、甲状旁腺素、碱性磷酸酶及骨钙素比较，MFF值变化出现较早。MFF与血磷（r=3.011, P＝0.003）、甲状旁腺素水平（r=3.852, P〈0.001）呈正相关性，与血钙（r=－2.767, P=0.017）、25（OH）D3（r=－6.032,P〈0.001）、eGFR （r=-5.104,P〈0.001）呈负相关性。多元线性回归分析，25（OH）D3 （Sβ=－0.343）及eGFR（Sβ＝－0.284,P均〈0.001）是MFF的独立影响因素。 结论 CKD非透析患者存在骨髓脂肪浸润，T2＊校正水脂分离MRI是定量CKD骨髓脂肪含量的有效手段。Objective To detect the changes in vertebral marrow fat fraction （MFF） using T2＊ -corrected water-fat MRI and to analyze the relationships between MFF with bone biomarkers of non-dialysis chronic kidney disease （CKD）. Methods 78 CKD patients were divided into five groups according to the eGFR and underwent water/fat MRI to obtain MFF.The reliability of MFF measurements by two radiologists was assessed with intra-class correlation coefficient （ICC）. Serum calcium, phosphorus, alkaline phosphatase,osteocalcin, intact parathyroid hormone and 25（OH）D3 were determined.Results Mean CV for MFF measurements reproducibility was 2.37%. The inter-observer agreement for MFF was excellent （ICC=0.901）.The ICC for each intra-observer agreement was excellent （ICC=0.959 and 0.948, respectively）. There were statistical differences in MFF among five groups of CKD.Changes of MFF were earlier than those of serum calcium, phosphorus,parathyroid hormone,alkaline phosphatase and osteocalcin.MFF was positively correlated with serum phosphorus （r=3.011,P=0.003）, parathyroid hormone （r=3.852, P〈0.001 ）,and negatively associated with calcium （r =- 2.767, P = 0.017 ）, 25 （OH） D3 （ r = - 6.032, P〈 0.001 ）, eGFR （ r=- 5.104, P〈0.001 ）, respectively. Muhivariable regression analysis showed MFF was negatively correlated with 25 （OH） D3 （ Sβ = - 0.343 ） and eGFR（Sβ=-0.284 ,P%0.001 ）. Conclusion CKD patients had higher marrow fat. T2 - -corrected water-fat MRI could serve as a useful tool to quantify marrow fat content for CKD patients.

关 键 词：磁共振成像 水/脂分离 骨髓脂肪 慢性肾脏病 

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]