BOLD MRI对2型糖尿病肾病患者肾功能损伤的评估价值研究  

Evaluated Value of BOLD MRI on Renal Function Impairment in Patients with Type 2 Diabetic Nephropathy

作　　者：郭永榜[1] 张晓亚[1] 郭青榜 殷洁[1] 向旭[1] 李建灵[1] 周勇[1] GUO Yong-bang;ZHANG Xiao-ya;GUO Qing-bang;YIN Jie;XIANG Xu;LI Jian-ling;ZHOU Yong(MR Room,Nanyang Central Hospital,Nanyang 473000,Henan Province,China;VIP Clinic,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市中心医院磁共振室,河南南阳473000 [2]南阳市中心医院特需科,河南南阳473000

出　　处：《中国CT和MRI杂志》2022年第4期121-123,168,共4页Chinese Journal of CT and MRI

摘　　要：目的探究血氧水平依赖磁共振成像(BOLD MRI)对2型糖尿病肾病患者肾功能损伤的评估价值。方法选择2018年12月至2019年12月我院收治的92例2型糖尿病肾病患者及30例性别比例、年龄与DN患者相匹配的健康志愿者(正常对照组)为研究对象,2型糖尿病肾病患者根据估算肾小球滤过率评价肾功能损伤分为早期2型糖尿病肾病组和中晚期DN组,研究对象均接受BOLD MRI检查,计算皮质表观自旋-自旋弛豫率(R2;)、髓质R2;及髓质/皮质R2;比值,以受试者工作特征曲线(ROC)评价BOLD MRI对2型糖尿病肾病患者肾功能损伤的评估价值。结果对照组肾皮、髓质R2;值均低于早期2型糖尿病肾病组和中晚期2型糖尿病肾病组,髓质/皮质R2;值低于早期2型糖尿病肾病组,高于中晚期2型糖尿病肾病组,差异均有统计学意义(P<0.05);早期2型糖尿病肾病组肾皮质R2;值高于中晚期2型糖尿病肾病组,肾髓质R2;值及髓质/皮质R2;值低于早期2型糖尿病肾病组,差异均有统计学意义(P<0.05);ROC曲线分析显示:肾髓质R2;值、皮质R2;值评价健康者与早期2型糖尿病肾病患者的曲线下面积(AUC)分别为0.989和0.756,评估截断值分别为32.59Hz和16.92Hz,敏感性分别为94.12%和52.94%,特异性分别为96.67%和90.00%;肾皮R2;值、髓质/皮质R2;值评价早期2型糖尿病肾病与中晚期2型糖尿病肾病患者的AUC依次为0.868和0.785,截断值依次为17.88Hz和2.20Hz,敏感性依次为82.93%和90.24%,特异性依次为86.27%和58.82%。结论BOLD MRI检查可评价2型糖尿病肾病患者肾功能损伤情况,肾髓质R2;值对健康者与早期2型糖尿病患者的诊断效能较高,肾皮质R2;值对早期和中晚期2型糖尿病肾病患者诊断效能较高。Objective To explore the evaluated value of blood oxygen level-dependent magnetic resonance imaging(BOLD MRI)on renal function impairment in patients with type 2 diabetic nephropathy.Methods From December 2018 to December 2019,92 patients with type 2 diabetic nephropathy and 30 healthy volunteers(normal control group)whose gender ratio and age were matched with DN patients in our hospital were selected as the research subjects.The patients with type 2 diabetic nephropathy were divided into early type 2 diabetic nephropathy group and middle-and-advanced DN group according to evaluation of renal function impairment by glomerular filtration rate.The subjects were examined by BOLD MRI,and the cortical apparent spin-spin relaxation rate(R2;),medulla R2;and medulla/cortex R2;ratio were calculated,and the receiver operating characteristic curve(ROC)was used to assess the evaluated value of BOLD MRI on renal function impairment in patients with type 2 diabetic nephropathy.Results The R2;values of renal cortex and medulla in control group were lower than those in early type 2 diabetic nephropathy group and middle-andadvanced type 2 diabetic nephropathy group,and the medulla/cortex R2;was lower than that in early type 2 diabetic nephropathy group(P<0.05).The renal cortex R2;value in early type 2 diabetic nephropathy group was higher than that in middle-and-advanced type 2 diabetic nephropathy group,and the renal medulla R2;value and medulla/cortex R2;value were lower than those in early type 2 diabetic nephropathy group(P<0.05).ROC curve analysis showed that the values of area under the curve(AUC)of renal medulla R2;value and cortex R2;value in evaluating the healthy people and early type 2 diabetic nephropathy patients were 0.989 and 0.756,and the estimated cutoff values were 32.59 Hz and 16.92 Hz,and the sensitivities were 94.12%and 52.94%,and the specificities were 96.67%and 90.00%.The AUC values of cortex R2;value and medulla/cortex R2;value in evaluating patients with early type 2 diabetic nephropathy and patients wit

关 键 词：血氧水平依赖磁共振成像 2型糖尿病肾病 肾功能损伤 评估价值 

分 类 号：R587.1[医药卫生—内分泌] R445.2[医药卫生—内科学]