定量磁共振技术T1 mapping在糖尿病肾病患者肾功能评估中的应用  

Quantitative T1 mapping in the evaluation of renalfunction for diabetic nephro pathypatients

作　　者：陆慧健 顾红梅[1] 商芳芳 袁莉[2] LU Huijian;GU Hongmei;SHANG Fangfang;YUAN Li(Department of Radiology,Affiliated Hospital of Nantong University,Jiangsu 226001;Department of nephrology,Affiliated Hospital of Nantong University,Jiangsu 226001)

机构地区：[1]南通大学附属医院影像科,江苏226001 [2]南通大学附属医院肾脏内科,江苏226001

出　　处：《交通医学》2022年第4期336-339,共4页Medical Journal of Communications

基　　金：南通市社会民生科技面上项目(MS12020042)。

摘　　要：目的:探讨定量磁共振技术T1 mapping在糖尿病肾病(DN)患者肾功能评估中的应用价值。方法:对65例DN患者,10例单纯糖尿病(DM)患者及20例健康志愿者(HVs)行MR T1 mapping检查,比较DN组、DM组和HVs组肾脏皮质T1值,分析DN患者肾脏皮质T1值与估算的肾小球滤过率(eGFR)及血肌酐(Scr)水平的相关性,采用ROC曲线分析肾脏皮质T1值鉴别DN与DM及HVs的诊断效能。结果:DN组肾脏皮质T1值1865.81±157.86 ms明显高于HVs组1604.51±103.51 ms和DM组1628.04±52.08 ms,差异均具有统计学意义(P<0.001),HVs组与DM组肾脏皮质T1值的差异无统计学意义(P>0.05)。DN组肾脏皮质T1值与eGFR呈显著负相关(r=-0.675,P<0.001),与Scr呈显著正相关(r=0.524,P<0.001)。ROC曲线分析结果显示,当鉴别HVs与DN时,T1值曲线下面积为0.912,灵敏度、特异度和临界值分别为0.909、0.90及1667.62 ms,当鉴别DM与DN时,T1值曲线下面积为0.88,灵敏度、特异度和临界值分别为0.836、0.90及1708.18 ms。结论:定量磁共振技术T1 mapping可以用于评估糖尿病肾病患者肾功能损伤情况。Objective:To explore the value of quantitative T1 mapping inassessing renal function of diabet icneph-ropathy patients.Methods:T1 mapping was performed on 55 diabetic nephropathy(DN)patients,10 diabetes mellitus(DM)patients and 20 healthy volunteers(HVs).The difference of T1 values among the three groups was compared.The relationship between T1 values and the estimated glomerular filtration rate(eGFR)and the serum creatinine(Scr)was also analyzed.Receiver operating curve(ROC)was applied to evaluate the efficacy of diagnosing DN from HVs and DM.Results:The difference of T1 values of renal cortex among HVs,DM and DN was significant(F=34.87,P<0.001).T1 value of renal cortex in DN 1865.81±157.86 ms was significantly higher than that in HVs 1604.51±103.51 ms and DM 1628.04±52.08 ms,the difference was statistically significant(t=6.939,P<0.001;t=4.739,P<0.001).There was no significant difference in T1 values of renal cortex between HVs and DM(t=0.673,P>0.05).T1 value of renal cortex in DN was significantly negatively correlated with eGFR(r=-0.675,P<0.001)and positively correlated with Scr(r=0.524,P<0.001).ROC analysis showed that the T1value of renal cortex had high differential diagnostic efficacy between DN and HVs and DM,the area under the curves(AUC)was 0.927,and the corresponding sensitivity,specificity,and cut-off value for T1 were 0.91,0.90 and 1683.15 ms,respectively.Conclusion:Quantitative T1 mapping can be used to evaluate the renal function injury in patients with DN.

关 键 词：糖尿病肾病 肾功能 定量磁共振技术 T1 mapping技术 

分 类 号：R587.2[医药卫生—内分泌]