肾脏缺氧分数评价慢性肾脏疾病的应用价值  

Application Value of the Fractional Kidney Hypoxia for the Assessment of Chronic Kidney Disease

作　　者：陈赟[1] 陈杰[1] 蒋振兴[1] 邢伟[1] CHEN Yun;CHEN Jie;JIANG Zhenxing;et al.(Department of Radiology, the Affiliated No. 3 Hospital of Suzhou University, Changzhou, Jiangsu Province 213003, P. R. China)

机构地区：[1]苏州大学附属第三医院放射科

出　　处：《临床放射学杂志》2018年第4期633-637,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金面上项目(编号:81371513)

摘　　要：目的探究在慢性肾脏疾病（CKD）患者的血氧水平依赖磁共振成像（BOLD-MRI）图像分析中运用肾脏缺氧分数方法的应用价值。方法对13名健康志愿者及32例CKD患者（CKD 1、2期及3-5期各16例,分为两组）行BOLD-MRI扫描。两名研究者各自独立运用传统ROI法及肾脏缺氧分数方法,进行图像分析及数据测算,并对两种方法进行对比分析。结果传统ROI法：正常对照组与CKD轻、中重度组MR2＊值及CKD轻、中重度组CR2＊值差异有统计学意义（P〈0.05）,而CKD轻度组与正常对照组间CR2＊值差异无显著性统计学意义（P=0.348）。CKD程度的加重伴随MR2＊值的升高。肾脏缺氧分数：各组间差异均有显著性统计学意义（P〈0.05）,且肾脏缺氧分数随CKD程度的加重而升高。绘制ROC曲线分析,肾脏缺氧分数曲线下面积大于MR2＊值方法,显示肾脏缺氧分数方法拥有更高的敏感性和特异性。运用信度分析可重复性显示肾脏缺氧分数方法有明显优势。结论肾脏缺氧分数方法在BOLD图像分析中更有优势,更适用于评估CKD患者的肾脏组织内缺氧水平。Objective To detect the application value of the fractional kidney hypoxia which was measured by using BOLD-MRI for the assessment of chronic kidney disease. Methods The renal BOLD-MRI was performed in 13 cases of healthy volunteers（ a control group） and 32 cases of chronic kidney disease patients（ divided into two groups both 16 cases,CKD1,2 period of mild group,CKD3-5 period of medium-severe group）. The BOLD-MRI data analysis was performed by two researchers with two different methods（ one is the conventional method,and another is fractional kidney hypoxia method）.Compare the two methods. Results 1. Conventional method：-there were significant statistical differences of medullary R2＊in each group and cortical R2＊between the CKD mild group and the medium-severe group（ P〈0. 05）. There was no statistical difference of cortical R2＊（ P = 0. 348）. Medullary R2＊values were associated with the period of CKD. 2. Fractional kidney hypoxia method：-statistical differences in each group（ P〈0. 05）,and the values were associated with the period of CKD. 3. Using ROC curve,we compared the two methods,fractional kidney hypoxia has higher sensitivity and specificity. 4. Cronbach＇s Alpha of the fractional kidney hypoxia was higher; the fractional kidney hypoxia method had better repeatability. Conclusion When renal BOLD-MRI is performed,the fractional kidney hypoxia method is more suitable to evaluate renal oxygenation content of CKD.

关 键 词：肾脏缺氧分数 血氧水平依赖成像 磁共振成像 慢性肾脏疾病 

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]