IVIM-DWI评价静脉水化对碘对比剂所致家兔肾损伤的预防效果  

Effect of venous hydration in preventing renal impairment after injection of iodinated contrast medium using IVIM-DWI

作　　者：由贺 任克[1] 刘璐[1] 王永芳[1] 孙文阁[1] 赵丽[1] YOU He;REN Ke;LIU Lu(Department of Radiology,the First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院放射科,沈阳110001

出　　处：《放射学实践》2019年第3期259-265,共7页Radiologic Practice

基　　金：国家自然科学基金面上项目(81571635);"数字诊疗装备研发"试点专项"MRI设备及其临床应用评价研究"(2016YFC0106900)

摘　　要：目的:采用IVIM-DWI评价注射碘对比剂前后静脉水化对碘对比剂所致肾脏损伤的预防效果。方法:36只健康雄性家兔,随机分成4组(每组9只)。A组:注射等量生理盐水;B组:碘对比剂注射前3h水化;C组:碘对比剂注射后3h水化;D组:注射等量碘对比剂。碘对比剂注射剂量为1 g I/kg,在注射后3 h、24 h、72 h对家兔进行肾脏IVIM-DWI检查。同时在对应时间点每组分别随机处死3只家兔,取右肾制作病理标本。结果:与A组相比,B、C、D三组在注射对比剂3 h肾脏皮、髓质D值、D~*值、f值均下降,B组皮质D值(5.91±0.66)×10^(-4)mm^2/s和髓质D值(5.35±0.82)×10^(-4)mm^2/s与对应C组皮质D值(4.90±0.93)×10^(-4)mm^2/s和髓质D值(4.29±0.73)×10^(-4)mm^2/s存在统计学差异(P<0.05),在24 h肾脏皮质D值、D~*值、f值降至最低,B组皮质D值(5.62±0.65)×10^(-4)mm^2/s、D~*值(7.86±0.48)×10^(-3)mm^2/s、f值(40.20±4.47)%与C组皮质D值(4.55±0.68)×10^(-4)mm^2/s、D~*值(6.82±0.40)×10^(-3)mm^2/s、f值(30.30±4.34)%存在统计学差异(P<0.05),72 h肾脏皮质D值、D~*值、f值呈现回升趋势,髓质D值、D~*值、f值下降至最低,B组髓质D值(5.09±0.21)×10^(-4)mm^2/s、D~*值(7.37±0.77)×10^(-3)mm^2/s、f值(34.10±5.14)%与C组髓质D值(4.01±0.58)×10^(-4)mm^2/s、D~*值(6.27±0.47)×10^(-3)mm^2/s、f值(25.70±3.35)%值存在统计学差异(P<0.05)。显微镜下观察病理切片,可见不同程度的肾小球和肾小管细胞混浊、肿胀、变性,集合管管型,间质充血,以D组病理损伤最重,B组病理损伤最轻。同时免疫组化水通道蛋白1(APQ1),D组表达增加最多,B组表达增加最少。结论:IVIM-DWI可有效评估注射碘对比剂前后静脉水化对碘对比剂所致的家兔肾损伤的保护作用,在注射碘对比剂前静脉水化、效果更好。Objective:To investigate IVIM-DWI on evaluation of the effect of venous hydration before and after the injection of iodinated contrast medium in preventing renal impairment. Methods:36 healthy male rabbits were randomly and equally divided into four groups (n=9 each).Rabbits in group A were injected with equal amount of saline.Rabbits in group B were hydrated 3 hours before injecting iodinated contrast medium.Rabbits in group C were hydrated 3 hours after injecting iodinated contrast medium.Rabbits in group D were injected with equal amount of iodinated contrast medium without hydration before or after.MRI IVIM-DWI was performed on the rabbit kidneys 3 hours,24 hours and 72 hours after the injection of iodinated contrast mediumat a dose of 1g I/kg.Upon the completion of each corresponding scan,3 rabbits in each group were randomly killed and their right kidneys were harvested and made into specimen. Results:The D value,D^* value and f value of renal cortex in the renal cortex decreased 3h after the injection of contrast agent,and the D value (5.91±0.66)×10^-4mm^2/s and medulla D value (5.35±0.82)×10^-4mm^2/s of the B group and the corresponding C group.Cortical D value (4.90±0.93)×10^-4mm^2/s and medullary D value (4.29±0.73)×10^-4mm^2/s were statistically different ( P <0.05),at 24h,renal cortex D value,D^* value,f value decreased to the lowest,group B cortical D value (5.62±0.65)×10^-4mm^2/s,D^* value (7.86±0.48)×10^-4mm^2/s,f value (40.20± 4.47)% and group C cortical D value (4.55±0.68)×10^-3mm^2/s,D^* value (6.82±0.40)× 10^-3mm^2/s, f value (30.30±4.34)%.There was a statistical difference ( P <0.05),72h,renal cortex D value,D^* value,f showed a rising trend,medulla D value,D^* value,f value decreased to the lowest,group B medulla D value (5.09±0.21)×10^-4mm^2/s,D^* value (7.37±0.77)×10^-3mm^2/s,f value (34.10±5.14)% and group C medullary D value (4.01±0.58)×10^-4mm^2/s,D^* value (6.27± 0.47)× 10^-3mm^2/s,f value (25.70±3.35)% value statistics Learning differences ( P <0.05).Differe

关 键 词：体素内不相干运动 静脉水化 碘对比剂 兔 

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]