2型糖尿病Gd-EOB-DTPA增强MRI肝肾影像改变  

Gd-EOB-DTPA enhanced MRI of liver and kidney in type 2 diabetes

作　　者：孙昊洋[1] 张文玉 张文龙 SUN Hao-yang;ZHANG Wen-yu;ZHANG Wen-long(Department of Radiology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250001,China)

机构地区：[1]山东中医药大学附属医院放射科,济南250001 [2]山东省肿瘤防治研究院(山东省肿瘤医院),山东第一医科大学(山东省医学科学院)影像科,济南250017

出　　处：《放射学实践》2024年第2期213-217,共5页Radiologic Practice

摘　　要：目的:探讨2型糖尿病(T2D)患者钆塞酸二钠(Gd-EOB-DTPA)增强MRI肝胆期的肝肾影像改变。方法:搜集82例接受Gd-EOB-DTPA增强MRI腹部检查的患者(肝肾功能正常),其中T2D患者34例(观察组),非T2D患者48例(对照组)。两位医师分别计算肝胆期肝脏相对信号强度(RL)、肾皮质和髓质相对信号强度(Rrc、Rrm)、肾皮髓质信号强度的相对差异(Rc-m)。采用独立样本t检验或Mann-Whitney U检验比较观察组与对照组的相关参数差异。选择组间差异有统计学意义的变量,使用受试者工作特征(ROC)曲线分析其鉴别T2D的效能;采用组内相关系数(ICC)评估其可重复性。结果:观察组的RL、Rc-m均较对照组降低,差异有统计学意义(P<0.05),两组的Rrc、Rrm差异均无统计学意义(P>0.05)。RL和Rc-m鉴别T2D的ROC曲线下面积分别为0.78和0.72,诊断敏感度分别为77.10%和64.60%,特异度分别为70.60%和79.40%。RL和Rc-m的观察者间一致性均较好,RL和Rc-m的ICC分别为0.91和0.89。结论:T2D患者Gd-EOB-DTPA增强MRI肝胆期肝肾RL和Rc-m降低。RL和Rc-m在一定条件下可能有助于鉴别T2D,其测量可重复性较好。Objective:To investigate the changes in liver and kidney images during the hepatobiliary phase of gadoxetate disodium(Gd-EOB-DTPA)enhanced MRI in patients with type 2 diabetes mellitus(T2D).Methods:Eighty-two patients with normal liver and kidney function who underwent abdominal Gd-EOB-DTPA enhanced MRI were collected,including 34 patients with T2D(observation group)and 48 patients without T2D(control group).The relative signal intensity(RI)of the liver in the hepatobiliary phase,the relative SI of the renal cortex and medulla(Rrc and Rrm),and the relative difference in the signal intensity of the renal corticomedulla(Rc-m)during the hepatobiliary phases were calculated respectively by two radiologists.The independent samples t-test or Mann-Whitney U statistic was used to compare the differences in relevant parameters between the observation and control groups.Statistically significant variables were selected,and the receiver operating characteristic(ROC)curve was used to analyze their efficacy in identifying T2D.The intraclass correlation coefficient(ICC)was used to evaluate the reproducibility.Results:RL and Rc-m in the observation group were significantly lower than those in the control group(P<0.05),and there was no statistically significant difference for Rrc and Rrm(P>0.05).The areas under the ROC curves for the identification of T2D by RL and Rc-m were 0.78 and 0.72,respectively.The sensitivity and specificity of RL and Rc-m in differentiating T2D were 77.10%,70.60%and 64.60%,79.40%,respectively.Both RL and Rc-m showed good inter-observer consistency,with ICC of 0.91 and 0.89 for RL and Rc-m,respectively.Conclusion:The RL and Rc-m of liver and kidney decreased during the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI in T2D patients.RL and Rc-m might help to identify T2D under certain conditions with good reproducibility.

关 键 词：2型糖尿病 GD-EOB-DTPA 磁共振成像 肝脏 肾脏 

分 类 号：R587.1[医药卫生—内分泌] R445.2[医药卫生—内科学]