体素内不相干运动成像定量评估慢性移植肾功能不全  

Intravoxel incoherent motion for quantitative evaluating chronic allograft dysfunction

作　　者：王盼 李向南[2] 郑鑫[3] 胡小鹏[4] 张琛 蒋涛[2] 李敏[2] WANG Pan;LI Xiangnan;ZHENG Xin;HU Xiaopeng;ZHANG Chen;JIANG Tao;LI Min(Department of Radiology,Beijing Fangshan District First Hospital,Beijing 102400,China;Department of Radiology,Capital Medical University,Beijing 100020,China;Urinary Surgery,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China;Urinary Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;MR Research Collaboration Team,Siemens Healthcare,Beijing 100102,China)

机构地区：[1]北京市房山区第一医院放射科,北京102400 [2]首都医科大学附属北京朝阳医院放射科,北京100020 [3]首都医科大学附属北京佑安医院泌尿外科,北京100069 [4]首都医科大学附属北京朝阳医院泌尿外科,北京100020 [5]西门子医疗有限公司磁共振科研合作部,北京100102

出　　处：《中国医学影像技术》2024年第1期93-97,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察弥散加权成像体素内不相干运动(IVIM)定量评估慢性移植肾功能不全(CAD)的价值。方法前瞻性纳入104例CAD患者,根据估算肾功能受损程度分为CAD 1、2、3组(n=11、61、32);另以36名健康志愿者为对照组。比较组间及组内肾皮、髓质IVIM参数真性弥散系数(D值)、微循环灌注弥散系数(D值)及灌注分数(f值),评价IVIM参数诊断CAD的价值。结果移植肾皮质D值在各CAD组均低于对照组(P均<0.05),且在1组、2组、3组依序减低(P均<0.05);CAD 2组、3组移植肾髓质D值均低于对照组(P均<0.05)。各CAD组移植肾皮质D值均低于对照组(P均<0.05),CAD 2组、3组肾髓质D值均低于对照组(P均<0.05)。CAD 2组、3组移植肾皮质、髓质f值均低于对照组(P均<0.05),CAD 3组移植肾皮质f值低于1组及2组(P均<0.05)。各组肾皮质D值、D值、f值均高于髓质(P均<0.05)。皮质IVIM联合模型诊断CAD的曲线下面积(AUC)为0.96,优于D值及f值(AUC=0.74、0.83,P均<0.05)而与D值(AUC=0.94)差异无统计学意义(P=0.32)。髓质IVIM联合模型诊断CAD的AUC为0.91,优于D值、D值及f值(AUC=0.80、0.67、0.80,P均<0.05)。结论IVIM参数可定量评估CAD。Objective To observe the value of diffusion weighted imaging intravoxel incoherent motion(IVIM)for quantitative evaluating chronic allograft dysfunction(CAD).Methods Totally 104 CAD patients were prospectively enrolled and were assigned into CAD 1,2 and 3 groups(n=11,61,32)based on impairment severity of estimated renal function,and 36 healthy volunteers were enrolled as control group.The true diffusion coefficient(D value),microcirculation perfusion diffusion coefficient(D value)and perfusion score(f value)of renal cortex and medulla IVIM parameters were compared among groups and within groups to assess the value of IVIM parameters for diagnosing CAD.Results The D value of transplanted renal cortex in all CAD groups were lower than that in control group(all P<0.05),which decreased among CAD 1,2 and 3 groups(all P<0.05).The D value of transplanted kidney medulla in CAD 2 and 3 groups were lower than that in control group(both P<0.05).The D values of transplanted renal cortex in all CAD groups were lower than that in control group,while of renal medulla in CAD 2 and 3 groups were lower than that in control group(both P<0.05).The f values of cortex and medulla in CAD 2 and 3 groups were lower than those in control group(all P<0.05),while of cortex in CAD 3 group was lower than that in CAD 1 and 2 groups(both P<0.05).The area under the curve(AUC)of cortical IVIM combined model for diagnosing CAD was 0.96,better than the D value and f value(AUC=0.74,0.83,P<0.05)but not significantly different with that of the D value(AUC=0.94,P=0.32).AUC of medullary IVIM combined model for diagnosing CAD was 0.91,better than that of D,D and f value(AUC=0.80,0.67 and 0.80,all P<0.05).Conclusion IVIM parameters could be used to quantitatively evaluate CAD.

关 键 词：肾移植 肾功能不全 慢性 磁共振成像 前瞻性研究 

分 类 号：R692[医药卫生—泌尿科学] R445.2[医药卫生—外科学]