血氧水平依赖性磁共振成像诊断痛风肾病的价值及其弛豫率与生理指标的相关性  

Diagnostic value of blood oxygenation level dependent-magnetic resonance imaging for gouty nephropathy and correlation between relaxation rate and physiological indexes

作　　者：黄海波[1] 管俊 黄桂雄 林莹 王坚[2] 黎萍 何振峰 李大创[1] HUANG Hai-bo;GUAN Jun;HUANG Gui-xiong;LIN Ying;WANG Jian;LI Ping;HE Zheng-feng;LI Da-chuang(Department of Radiology,2 Department of Urology,the 303rd Hospital of the Chinese People′s Liberation Army,Nanning 530021,China)

机构地区：[1]中国人民解放军第303医院影像科,南宁市530021 [2]中国人民解放军第303医院泌尿科,南宁市530021

出　　处：《广西医学》2018年第15期1656-1659,共4页Guangxi Medical Journal

基　　金：中国人民解放军第303医院青年基金重点项目(2016008)

摘　　要：目的探讨血氧水平依赖性磁共振成像(BOLD-MRI)诊断痛风肾病的价值及其弛豫率(R2*)与生理指标的相关性。方法选取65例痛风肾病患者(病例组)和15名健康对照者(对照组)作为研究对象,并根据肾脏病预后质量倡议工作组提出的标准将病例组患者分Ⅰ~Ⅴ期。应用3.0 T MRI扫描研究对象的肾脏,比较两组研究对象肾皮质、髓质R2*值,采用受试者工作特征曲线评估髓质R2*诊断痛风肾病的价值,分析病例组R2*与肾功能的相关性。结果病例组髓质R2*、估算肾小球滤过率(e GFR)低于对照组,尿酸(UA)、血清肌酐(SCr)高于对照组(均P<0.05)。髓质R2*≤27.61 Hz时诊断痛风肾病的准确性为87.3%,敏感度和特异度分别92.2%和80.0%。对照组髓质R2*、e GFR高于Ⅱ~Ⅳ期患者,Ⅰ期髓质R2*、e GFR高于Ⅲ~Ⅳ期,Ⅱ期髓质R2*、e GFR高于Ⅳ期(均P<0.05);对照组UA、SCr低于Ⅱ~Ⅳ期患者,Ⅰ期UA、SCr低于Ⅲ~Ⅳ期,Ⅱ期UA、SCr低于Ⅳ期(均P<0.05)。相关分析结果显示,痛风肾病患者的髓质R2*值与e GFR呈正相关,与UA、SCr呈负相关(均P<0.05)。结论痛风肾病患者的髓质R2*与肾功能相关,BOLD-MRI诊断痛风肾病有一定的价值。Objective To investigate the diagnostic value of blood oxygenation level dependent-magnetic resonance imaging（BOLD-MRI） for gout nephropathy and the correlation between relaxation rate（R2＊） and physiological indexes. Methods Sixty-five patients with gouty nephropathy were enrolled as case group,and 15 healthy people as control group. The patients in the case group were identified as stage Ⅰ-Ⅴ according to the criteria of the Kidney Disease Outcomes Quality Initiative（K/DOQI）. Kidney scan was performed by 3. 0 T MRI. The kidney cortical and medullary R2＊values were compare between the two groups,the value of medullary R2＊value for diagnosing gouty nephropathy was assessed by receiver operating characteristic curve,and the correlation of R2＊value with kidney function was analyzed in the case group. Results The medullary R2＊value and estimated glomerular filtration rate（e GFR） were lower while the levels of uric acid（UA） and serum creatinine（SCr） were higher in the case group compared to the controls（all P〈0. 05）. The accuracy,sensibility and specificity were 87. 3%,92. 2% and 80. 0%,respectively,for predicting gouty nephropathy when the medullary R2＊value≤27. 61 Hz. The medullary R2＊value and e GFR in the control group were higher than those in the patients of stage Ⅱ-Ⅳ,the medullary R2＊value and e GFR in the patients of stage Ⅰ were higher than those in the patients of stage Ⅲ-Ⅳ,and the medullary R2＊value and e GFR of stage Ⅱ were higher than those of stage Ⅳ（all P〈0. 05）; the levels of UA and SCr in the control group were lower than those in the patients of stage Ⅱ-Ⅳ,the levels of stageⅠwere lower than those of stage Ⅲ-Ⅳ,and the levels of stage Ⅱ were lower than those of stage Ⅳ（all P〈0. 05）. The results of correlation analysis showed that the medullary R2＊value positively correlated with e GFR but negatively correlated with UA and SCr in the patients with gouty nephropathy（all P〈0. 05）. Conclusion The medullary

关 键 词：痛风肾病 血氧水平依赖性磁共振成像 弛豫率 诊断价值 生理指标 

分 类 号：R589.7[医药卫生—内分泌]