血氧水平依赖磁共振成像在评估慢性肾小球肾炎患者肾脏功能及病理损伤中的应用  

BOLD-MRI in Evaluation of Renal Function and Pathological Injury in Chronic Glomerular Nephritis

作　　者：王欣全[1] 顾红梅[1] 严加欣 袁莉[2] 施钊钰 WANG Xinquan;GU Hongmei;YAN Jiaxin(Department of Imaging,Affiliated Hospital of Nantong University,Nantong,Jiangsu Province 226200,P.R.China)

机构地区：[1]南通大学附属医院影像科,226200 [2]南通大学附属医院肾内科,226200

出　　处：《临床放射学杂志》2023年第12期1962-1967,共6页Journal of Clinical Radiology

基　　金：国家重点研发计划“中医药现代化研究”重点专项项目(编号:2019YFCl709402);江苏省中医药科技发展计划项目(编号:YB201985);南通市科技局项目(编号:MSl2020042)。

摘　　要：目的探讨血氧水平依赖磁共振成像(BOLD-MRI)在定量评估慢性肾小球肾炎(CGN)患者肾功能及病理损伤的应用价值。方法对19名健康志愿者和53例经肾活检确诊的CGN患者行BOLD-MRI检查,并测量肾皮髓质R_(2)^(*)值,记录临床资料及肾脏病理积分,分析R_(2)^(*)值与CGN患者肾功能及病理损伤的关系。结果对照组与轻度损伤CGN组、中重度损伤CGN组肾皮髓质R_(2)^(*)值均有统计学意义(F=10.171,P<0.001;F=19.666,P<0.001)。皮髓质R_(2)^(*)值与肾小球滤过率估计值(eGFR)分别呈负、正相关(r=-0.570,P<0.001;r=0.357,P<0.009),肾皮髓质R_(2)^(*)值与胱抑素C、病理积分均有相关性,肾皮髓质R_(2)^(*)值鉴别对照组与轻度损伤CGN组,受试者工作特征曲线(ROC)曲线下面积(AUC)分别为0.634和0.667,鉴别对照组与中重度损伤CGN组,AUC分别为0.842和0.939。结论BOLD-MRI对评估CGN患者肾功能及病理损伤程度具有重要价值。Objective To explore the value of blood oxygen level-dependent magnetic resonance imaging(BOLD-MRI)in quantitative assessment of renal function and pathological damage degree in patients with chronic glomerular nephritis(CGN).Methods Blood oxygen level dependent magnetic resonance imaging was used on 19 healthy volunteers and 53 CGN patients.The R2*value of renal cortex and medulla was measured.The clinical data and renal pathological scores were recorded,and the relationship between renal R_(2)^(*)value and renal function and pathological injury in CGN patients was analyzed.Results The R_(2)^(*)values of renal cortex and medulla in the control group,mild injury CGN group and moderate-severe injury CGN group were statistically significant(F=10.171,P<0.001;F=19.666,P<0.001).The R_(2)^(*)values of renal cortex and medulla were negatively and positively correlated with eGFR(r=-0.570,P<0.001;r=0.357,P<0.009).The R_(2)^(*)values of renal cortex and medulla were correlated with all pathological scores and Cystatin C.The areas under the ROC curve(AUC)of cortical and medullary R_(2)^(*)values were 0.634 and 0.667 respectively when differentiating the control group from the mild injury CGN group.The AUC of cortical and medullary R_(2)^(*)values were 0.719 and 0.729 respectively when differentiating the control group from the moderate-severe injury group.Conclusion BOLD-MRI has the important predictive value for renal function and pathological damage degree in patients with CGN.

关 键 词：血氧水平依赖 磁共振成像 慢性肾小球肾炎 肾功能 肾脏病理 

分 类 号：R445.2[医药卫生—影像医学与核医学] R692.31[医药卫生—诊断学]