慢性肾病患者右肾皮髓质的APT与mDixon-Quant相关性研究  

Study on the correlation between APT and mDixon-Quant in the right renal cortex and medulla of patients with chronic kidney disease

作　　者：王悦[1,2] 刘爱连 鞠烨[1,2] 杜长谕 姜昊洋[3] 戚伶俐 卜欣淼 胡文君 王楠 王家正 WANG Yue;LIU Ailian;JU Ye;DU Changyu;JIANG Haoyang;QI Lingli;BU Xinmiao;HU Wenjun;WANG Nan;WANG Jiazheng(Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center,Dalian 116011,China;Dalian Medical University,Dalian 116044,China;Philips Healthcare,Shanghai 200040,China)

机构地区：[1]大连医科大学附属第一医院放射科,大连116011 [2]大连市医学影像人工智能工程技术研究中心,大连116011 [3]大连医科大学,大连116044 [4]飞利浦(中国)投资有限公司,上海200040

出　　处：《磁共振成像》2022年第3期71-75,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的 探究慢性肾病(chronic kidney disease,CKD)患者右肾皮髓质酰胺质子转移成像(amide proton transfer,APT)参数APT值与mDixon-Quant序列参数表观弛豫率(R2;)、脂肪分数(fat fraction,FF)间的相关性。材料与方法 回顾性收集2019年8月至2020年10月行3.0 T磁共振扫描仪(Ingenia CX, Philips, Poland)检查的CKD患者病例资料共30例(女15例,男15例),根据估算肾小球滤过率(estimation of glomerular filtration rate,eGFR)将患者分为轻度肾损害组(14例)及中重度肾损害组(16例),同时收集22例健康志愿者资料作为对照组。将所有原始图像导入ISP工作站,生成伪彩图,分别从肾的上极、中部、下极各选择一个层面,把ROI分别放置在皮质和髓质中,面积约10~20 mm^(2),避开肾窦、大血管及肾周组织。采集数据应用SPSS 26.0进行统计学分析,数据不符合正态分布情况下,采用斯皮尔曼检验各组皮髓质的APT值与R2;及FF值的相关性,P<0.05为差异具有统计学意义。结果 CKD患者中重度肾损害组皮质APT值与皮质FF值呈正相关,差异具有统计学意义(P<0.05);而髓质APT值与R2;值无相关性。健康对照组及轻度肾损害组皮髓质APT值与R2;及FF值均无相关性。结论 CKD中重度肾损害组肾皮质APT值与mDixon-Quant序列的FF值呈正相关,二者可从不同角度反映肾损害时肾组织蛋白质代谢、酸碱环境变化及脂沉积的关系,具有评估CKD肾损害程度的潜在临床应用价值。Objective: To explore the correlation between amide proton transfer(APT) value of right renal cortex and medulla and R2;value and fat fraction(FF) value of m Dixon-Quant sequence in patients with chronic kidney disease(CKD). Materials and Methods: From Aug 2019 to Oct 2020, 30 patients with CKD(15 females and 15 males) who had undergone magnetic resonance examination on a 3.0 T MR scanner(Ingenia CX, Philips, Poland) were enrolled. They were divided into mild renal damage group(14 cases) and severe renal damage group(16 cases) according to estimation of glomerular filtration rate(eGFR), and 22 healthy volunteers were enrolled as control group. Import all the original images into ISP workstation to generate pseudo-color images. Select three positions from the upper, middle and lower parts of kidney, then place ROIs in cortex and medulla, with an area of about 10-20 mm;, avoiding renal sinus, great vessels and perirenal tissues. SPSS 26.0 was used for statistical analysis of the data. When the data did not conform to normal distribution,Spearman test was used to test the correlation between APT values of cortex and medulla and R2;, FF values of each group. P<0.05 was statistically significant. Results: There was a positive correlation between APT and FF values in the cortex of patients with severe renal impairment(P<0.05). There was no correlation between medullary APT values and R2;values. APT values of cortex or medulla had no correlation with R2;and FF values in healthy volunteers and patients with mild renal impairment. Conclusions: APT values in renal cortex of patients with severe renal impairment due to CKD is positively correlated with FF values of mDixon-Quant sequence, which can reflect the relationship among protein metabolism, acid-base environment and lipid deposition in renal tissue in different views,which had a potential clinical value of assessing the degree of renal damage in CKD.

关 键 词：酰胺质子转移 mDixon-Quant技术 慢性肾病 R2 脂肪分数 肾损害 相关性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R692.5[医药卫生—诊断学]