MRI多b值DWI成像对慢性肾病患者分期的评估价值研究  

Evaluated Value of MRI Multiple B-value DWI Imaging in the Staging of Patients with Chronic Kidney Disease

作　　者：郭永榜[1] 张晓亚[1] 郭青榜 殷洁[1] 吕国义[1] 李建灵[1] 张颖雪 GUO Yong-bang;ZHANG Xiao-ya;GUO Qing-bang;YIN Jie;LYU Guo-yi;LI Jian-ling;ZHANG Ying-xue(Department of Magnetic Resonance Imaging,Nanyang Central Hospital,Nanyang 473000,Henan Province,China;Department of 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5期142-144,共3页Chinese Journal of CT and MRI

摘　　要：目的 探讨核磁共振(MRI)多b值弥散加权(DWI)成像对慢性肾病患者分期的评估价值。方法纳入2018年10月至2019年10月我院90例临床确诊的糖尿病肾病(DN)患者为观察组,以及同时期90例健康志愿者作为对照组,参照相关分期标准,将观察组患者分为DN早期组(54例)、DN中晚期组(36例),对比b值分别为50、300、500、800s/mm^(2)下DN中晚期组、DN早期组、对照组肾皮质ADC值,并分析观察组不同b值下ADC值与肾小球滤过率(GFR)相关性。结果 b值取50、100s/mm^(2)时,DN中晚期组肾皮质ADC值低于DN早期组与正常对照组(P<0.05),DN早期组与对照组肾皮质ADC值差异无统计学意义(P>0.05);b值取500、800s/mm^(2)时,正常对照组、DN早期组、DN中晚期组肾皮质ADC值呈下降趋势(P<0.05);观察组肾皮质ADC值与GFR呈正相关(b值取值50、300、500、800s/mm^(2)时,r分别为0.649、0.624、0.568、0.577,P均<0.05)。结论 MRI多b值DWI成像在DN的分期及肾功能状态的定量评估中具有一定应用价值,可作为一种无创性的肾功能评估手段。Objective To investigate the evaluated value of multiple b-value diffusion weighted imaging(DWI) of magnetic resonance imaging(MRI) in the staging of patients with chronic kidney disease. Methods From October 2018 to October 2019, 90 clinically diagnosed patients with diabetic nephropathy(DN)in our hospital were included in observation group, and 90 healthy volunteers during the same period were used as control group. According to the relevant staging criteria, the patients in observation group were divided into early DN group(54 cases) and middle-and-advanced DN group(36 cases). The renal cortical ADC values were compared among middle-and-advanced DN group, early DN group and control group under b values of 50, 100, 500 and 800s/mm^(2)respectively, and the correlation between ADC value and glomerular filtration rate(GFR) under different b values was analyzed in observation group. Results When the b value was 50 or 300s/mm^(2), the renal cortical ADC value in middle-andadvanced DN group was lower than that in early DN group and that in normal control group(P<0.05),and there was no statistically significant difference in the renal cortical ADC value between early DN group and control group(P>0.05). When the b value was 500 or 800s/mm^(2), the renal cortical ADC value in normal control group, early DN group and middle-and-advanced DN group showed a downward trend, and there was a statistically significant difference among the any two groups of the three groups(P<0.05). The renal cortical ADC value in observation group was positively correlated with GFR(b value=50, 300, 500, 800s/mm^(2), r=0.649, 0.624, 0.568, 0.577, all P<0.05). Conclusion MRI multiple b-value DWI imaging has certain application value in the quantitative evaluation of DN staging and renal function status, and can be used as a noninvasive evaluation method of renal function.

关 键 词：磁共振 多b值 弥散加权成像 糖尿病肾病 分期 评估价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R587.1[医药卫生—诊断学]