多b 值DWI在糖尿病肾病的初步应用研究  

The application research of Multi b-value Diffusion-Weighted-Imaging on the kidney of diabetic nephropathy

作　　者：郭永榜[1] 董国礼[2] 殷洁[1] 张晓亚[1] 李建灵[1] 向旭[1] GUO Yong-bang;DONG Guo-li;YIN Jie;ZHANG Xiao-ya;LI Jian-ling;XIANG Xu(Nanyang City Center Hospital,Nanyang 473000,Henan;Affiliated Hospial of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]南阳市中心医院,河南南阳473000 [2]川北医学院附属医院,四川南充637000

出　　处：《川北医学院学报》2019年第2期208-211,共4页Journal of North Sichuan Medical College

基　　金：四川省卫生厅科研项目(090147)

摘　　要：目的:探讨3.0 T磁共振多b值弥散加权成像(diffusion weighted imaging,DWI)及表观弥散系数(apparent diffusion coefficient,ADC)对早期糖尿病肾病(diabetic nephropathy,DN)的诊断价值。方法:选择临床确诊的55例糖尿病肾病患者和60名健康志愿者作为研究对象。采用3.0 T MRI对肾脏进行DWI扫描,b值选取0、50、100、300、500、800 s/mm^2,定量测量各组肾脏皮质及髓质值。结果:当b值为50、100 s/mm^2时,正常对照组与DN早期组皮质、髓质分别比较ADC值,差异无统计学意义(P>0.05);b值为300 s/mm^2时,正常对照组与DN早期组髓质比较ADC值,差异无统计学意义(P=0.118);其余各b值下,正常对照组、DN早期组及DN中晚期组的肾脏皮质、髓质ADC值两两比较,差异均有统计学差异(P<0.05)。各b值下,正常对照组、DN早期组和DN中晚期组的皮质及髓质ADC值均依次减低。结论:3.0 T MRI多b值DWI可以用于DN的早期诊断和DN分期的鉴别诊断,亦可作为临床治疗DN疗效评价和疾病发展进程的参考指标。Objective:To investigate the diagnostic value of ADCs in early diabetic nephropathy and different stages with 3.0T MR Multi b-value diffusion-weighted imaging(DWI). Methods:55 patients with diabetic nephropathy and 60 healthy volunteers were selected as the study subjects.All patients underwent a 3.0T MR scan with multi-b DWI.B value was selected as 0,50,100,300,500,800s/mm^2,renal cortex and medullary ADC values were measured on a post-processing workstation. Results:There was no significant difference of ADCs of renal cortex and medulla between early diabetic nephropathy(DN) group and normal control group with use of b of 50,100s/mm^2 ( P >0.05).When the b value was 300 s/ mm^2,there was no significant difference in ADC value between the normal control group and the early DN group ( P =0.118).The ADC values of renal cortex and medulla in the normal control group,the early DN group and the middle and late DN group were significantly different under the other b values ( P <0.05).The ADC values of cortex and medulla in normal control group,early DN group and middle and late DN group decreased in turn. Conclusion: 3.0 T MR Multi b-value DWI could be used for the DN early diagnosis and differential diagnosis of DN in different stages,could be used as a clinical DN reference index of curative effect evaluation and disease development process.

关 键 词：糖尿病肾病 扩散加权成像 磁共振成像 表观弥散系数 

分 类 号：R692[医药卫生—泌尿科学]