动脉自旋标记MRI在糖尿病肾病中的评估价值:Meta分析  

ASL MRI Imaging in Evaluation of Diabetic Kidney Disease:A Meta-Analysis

作　　者：张欣悦 陆方[2] 杨婧[1] 叶朝阳 王琛[1] ZHANG Xinyue;LU Fang;YANG Jing(Department of Nephrology/Rradiology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,P.R.China)

机构地区：[1]上海中医药大学附属曙光医院肾内科,201203 [2]上海中医药大学附属曙光医院放射科,201203

出　　处：《临床放射学杂志》2024年第10期1761-1766,共6页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(编号:81973770);上海市浦东新区卫生系统重点学科群建设资助项目(编号:PWZxq2017-07)。

摘　　要：目的通过Meta分析系统评价动脉自旋标记(ASL)成像技术对糖尿病肾病(DKD)的评估价值。方法检索PubMed、Embase、Web of Science、Cochrane Library、中国知网(CNKI)、中国生物医学文献数据库(SinoMed)、万方数据库、维普数据库,搜集ASL对DKD评估的研究文献,检索时间为2013年1月至2023年12月。采用Revman 5.4、Stata 16.0软件计算各DKD分组及对照组肾血流量(RBF)值的加权均数差值(WMD)和95%可信区间(CI)。结果共纳入文献9篇,诊断数据均为肾皮质RBF。RBF值随着DKD分期的加重而呈降低趋势。总体DKD患者RBF值显著低于对照组RBF值,WMD=-75.62(95%CI:-90.05,-61.20),P<0.01;DKD早期患者RBF值显著低于对照组RBF值,WMD=-39.73(95%CI:-47.14,-32.33),P<0.01;DKD中晚期患者RBF值显著低于DKD早期患者RBF值,WMD=-48.46(95%CI:-72.23,-24.68),P<0.01;DKD临床前期患者RBF值低于对照组,WMD=-12.38(95%CI:-20.46,-4.29),P<0.01。结论ASL在DKD分期评估及早期诊断方面具有良好诊断价值,定量监测肾皮质RBF值能够在DKD诊断及决策中发挥作用。Objective To evaluate the value of arterial spin labeling(ASL)imaging technique in the assessment of diabetic kidney disease(DKD)by Meta-analysis.Methods Searching the Pubmed,Embase,Web of Science,Cochrane Library,China Knowledge(CNKI),China Biomedical Literature Database(SinoMed),Wanfang,and Wipu databases to collect the research literature on ASL assessment of DKD from January 2013 to December 2023.Using Revman 5.4 and Stata 16.0 softwaretocalculate the weighted mean difference(WMD)and 95%confidence interval(CI)of renal blood flow(RBF)values for each DKD subgroup and control group.Results A total of 9 papers were included in the literature,and the diagnostic data were all renal cortical RBF.The RBF values tended to decrease with increasing DKD stage.Overall DKD patients had significantly lower RBF values than control RBF values,WMD=-75.62(95%CI:-90.05,-61.20),P<0.01;early DKD patients had significantly lower RBF values than control RBF values,WMD=-39.73(95%CI:-47.14,-32.33),P<0.01;patients with intermediate to late stage DKD RBF values were significantly lower than those of patients with early DKD,WMD=-48.46(95%CI:-72.23,-24.68),P<0.01;and those of patients with preclinical stage of DKD were lower than those of the control group,WMD=-12.38(95%CI:-20.46,-4.29),P<0.01.Conclusion ASL has good diagnostic value in staging assessment and early diagnosis of DKD,and quantitative monitoring of renal cortical RBF values can play a role in DKD diagnosis and decision-making.

关 键 词：糖尿病肾病 动脉自旋标记 磁共振成像 肾血流量 META分析 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学] R445.2[医药卫生—临床医学]