多期相动脉自旋标记序列在健康供肾者及肾肿瘤患者的肾灌注及肾功能相关性评价中的应用  

Renal Perfusion and Relevant Function Evaluation in Healthy Donors and Patients with Renal Tumors: A Multi-Inversion-Time Arterial Spin-Labeling Imaging Study

作　　者：郭文彬 史浩[2] 郑应心 葛亚平[2] 方强[4] 曹鑫 GUO Wenbin;SHI Hao;ZHENG Yingxin(Department of Radiology, Qilu Children＇ s Hosptial of Shandong University,Jinan, Shandong Province 250012 ,P. R. China)

机构地区：[1]山东大学齐鲁儿童医院放射科,250012 [2]山东省千佛山医院影像科,济南250014 [3]山东省济南市章丘区人民医院(济南市第六人民医院)放射科,250200 [4]泰山医学院,271000 [5]山东大学临床医学院,250012

出　　处：《临床放射学杂志》2018年第4期645-650,共6页Journal of Clinical Radiology

摘　　要：目的探讨多期相动脉自旋标记序列（mTI-PASL）评价健康供肾者及肾肿瘤患者肾功能的准确性及其在肾肿瘤中的应用。方法搜集35例健康供肾者及20例单侧肾肿瘤患者分别作为供肾者组及肾肿瘤组,应用西门子3.0 T磁共振进行m TI-PASL扫描及常规MRI扫描,得到肾脏肾血流量（RBF）值及血流达峰时间（BAT）值,并且所有受试者均行核医学^99mTc-DTPA肾动态显像方法测定肾小球滤过率（GFR）作为评价肾功能的参照标准,采用SPSS 22.0软件对数据进行统计学分析,将两侧肾脏RBF值及BAT值分别与GFR进行Pearson相关性分析;采用两样本t检验分析比较供肾者组、肾肿瘤两侧肾RBF值及BAT值的差异。结果供肾者组两侧肾RBF值分别为：左侧（141±13）ml·100g^-1·min^-1、右侧（147±14）ml·100g^-1·min^-1,每侧肾RBF值与其同侧肾GFR呈正相关（P〈0.001）,两侧BAT值分别为：左侧（384±33）ms、右侧（382±21）ms,每侧肾BAT值与同侧GFR呈负相关（P〈0.001）;肾肿瘤组每侧RBF值及BAT值与同侧GFR相关性差,无统计学意义;供肾者组两侧肾RBF、两侧BAT值差异无统计学意义（P〉0.05）;肾肿瘤组患侧较健侧肾RBF值[患侧（166±23）ml·100g^-1·min^-1,健侧（136±11）ml·100g^-1·min^-1]明显增高（P〈0.001）,BAT值[患侧（375±25）ms,健侧（401±38）ms]明显缩短（P=0.016）。结论 mTI-PASL可作为一种无创的供肾者术前常规检查肾功能的新方法,同时该方法也可为肿瘤肾的灌注提供一定的参考,为将来近一步的研究提供依据。Objective This study aimed to demonstrate the accuracy of using prototype multi-inversion time arterial spin labeling（ m TIPASL） for the assessment of renal function and renal tumors,as well as the application of m TIPASL in renal tumors. Methods Thirty-five kidney donors were enrolled as the＂healthy group＂and twenty patients were used as the ＂patient group＂. Conventional MR and ASL were collected on a Magnetom 3 T MR scanner. All subjects in both the healthy and patient groups underwent the -（99） mTc-DTPA renal dynamic imaging exam for measuring GFR as the standard value of renal function. The statistical data is processed by SPSS 22. 0 software. The Pearson correlation coefficients between RBF/BAT and GFR for the bilateral renal sides were calculated in both healthy and patient groups. In healthy and patient groups,a two-sample t-test between the RBF/BAT value was performed to test the differences between tumor and healthy renal tissues. Results The RBF of healthy subjects（ right side： 147 ± 14 ml · 100 g^-1· min^-1,left side： 141 ± 13 ml·100 g^-1·min^-1 had a highly positive correlation（ P〈0. 001） with GFR,while the BAT values（ right side： 382 ± 21 ms,left side： 384 ± 33 ms） had a negative correlation（ P〈0. 001） with GFR. In patient group,the RBF and BAT value of each side had no significant correlation with GFR of the same side. In healthy group,the left and right side renal RBF and BAT value were not statistically significant（ P〈0. 05）,In the patient group,the RBF（ 166 ± 23 ml·100 g^-1·min^-1）increased significantly（ P〈0. 001） and BAT（ 375 ± 25 ms） was significantly shorter（ P = 0. 016） in the T-side compared to the C-side（ RBF 136 ± 11 ml·100 g^-1·min^-1 BAT 401 ± 38 ms）. Conclusion The m TI-ASL as a new preoperative routine examination method can assess renal function non-invasively in heathy renal donors. This may also provide a reference for the degree of renal tumor malignity and should be further investigated.

关 键 词：磁共振成像 多期相动脉自旋标记 肾移植 肾肿瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.11[医药卫生—诊断学]