DKI序列在诊断早期糖尿病肾病中的应用  

Application of DKI Sequence in Diagnosis of Early Diabetic Nephropathy

作　　者：朱俊 张凤翔[2] 张芳[2] ZHU Jun;ZHANG Feng-xiang;ZHANG Fang(Ordos Clinical Medical College,Baotou Medical College,Inner Mongolia University of Science and Technology,Inner Mongolia 017000,China;Ordos Central Bospital,Inner Mongolia 017000,China)

机构地区：[1]内蒙古科技大学包头医学院鄂尔多斯临床医学院,内蒙古017000 [2]鄂尔多斯市中心医院,内蒙古017000

出　　处：《影像技术》2023年第2期28-33,共6页Image Technology

摘　　要：目的:探讨弥散峰度成像(DKI)诊断早期糖尿病肾病的可行性。方法:前瞻性收集2021年10月-2022年10月鄂尔多斯市中心医院早期DN患者20例和DM患者22例以及对照组22例,所有受试者均行常规MRI及DKI扫描,从b=0s/mm2图像中手工绘制肾皮质和髓质感兴趣区(ROI),并投影到相应的MD和MK图上。采用配对样本t检验比较所有受试者皮、髓质MK值及MD值的差异。使用Spearman等级相关分析DKI参数与糖尿病进展的相关性,三组参数的组间比较采用Kruskal-Wallis检验,如证实存在差异,则使用ROC曲线分析DKI参数对DN及DM的诊断效能。结果:所有受试者皮质MK值小于髓质MK值(P<0.001),皮质MD值大于髓质MD值(P<0.001)。肾皮髓质MK值在对照组到DN组呈上升趋势(r=0.712和0.714,P<0.001),MD值呈下降趋势(r=-0.443和-0.434,P<0.001)。三组组间皮髓质MK、MD值存在显著差异(P<0.001)。结论:弥散峰度成像(DKI)对早期DN的诊断有一定的价值,其中皮、髓质MK值均有较高的诊断效能。Objective:to explore the feasibility of diffusion kurtosis imaging(DKI)in the diagnosis of early diabetic nephropathy.Methods:from October 2021 to October 2022,20 patients with early DN and 22 patients with DM in Ordos Central Hospital and 22 controls were prospectively collected.All subjects underwent routine MRI and DKI scans.The renal cortex and medulla regions of interest(ROI)were manually drawn from b=0s/mm2 images and projected onto the corresponding MD and MK images.The differences of MK and MD in skin and medulla of all subjects were compared by paired sample t-test.Spearman rank correlation was used to analyze the correlation between DKI parameters and diabetes progression.Kruskal-Wallis test was used to compare the three groups of parameters.If there was a difference,ROC curve was used to analyze the diagnostic efficacy of DKI parameters for DN and DM.Results:the MK value of cortex was lower than that of medulla(P<0.001),and the MD of cortex was higher than that of medulla(P<0.001).The MK value of renal cortex and medulla increased from the control group to the DN group(r=0.712 and 0.714 P<0.001),while the MD value showed a downward trend(r=0.443 and-0.434 P<0.001).There were significant differences in MK and MD among the three groups(P<0.001).Conclusion:diffusion kurtosis imaging(DKI)has a certain value in the diagnosis of early DN,in which the MK values of cortex and medulla have higher diagnostic efficiency.

关 键 词：磁共振成像 糖尿病肾病 弥散峰度加权 肾功能损伤 

分 类 号：R445.3[医药卫生—影像医学与核医学]