动脉自旋标记MRI诊断糖尿病性肾病早期血液动力学变化的研究  

Study on Hemodynamic Changes in Early Diagnosis of Diabetic Nephropathy with Arterial Spin Labeling MRI

作　　者：甘俊 甘敏 吴锡[1] 张平[3] GAN Jun;GAN Min;WU Xi;ZHANG Ping(Department of Endocrinology,The People's Hospital of Jianyang City,Chengdu 641400,Sichuan Province,China;Department of Endocrinology,The Fourth People's Hospital of Ziyang City,Ziyang 641100,Sichuan Province,China;Department of Endocrinology,West China Hospital,Sichuan University,Chengdu 611530,Sichuan Province,China)

机构地区：[1]简阳市人民医院内分泌科,四川成都641400 [2]资阳市第四人民医院分泌科,四川资阳641100 [3]四川大学华西医院内分泌科,四川成都611530

出　　处：《中国CT和MRI杂志》2025年第1期131-133,共3页Chinese Journal of CT and MRI

基　　金：四川省科技厅2023年第一批省级科技计划(23NSFSC0708)。

摘　　要：目的 探讨动脉自旋标记(ASL)MRI对糖尿病(DM)慢性肾脏病(CKD)不同阶段肾血流动力学损害的诊断价值。方法 应用3T ASL-MRI对91例受试者(46例健康志愿者和45例2型糖尿病患者)的肾血流量(RBF)进行检测。根据估计的肾小球滤过率(EGFR)将患者分为Ⅰ组(EG FR>60m L/min/1.73m^(2))、Ⅱ组(60≥EGF R>3 0 m L/min/1.73 m^(2))或Ⅲ组(EGFR≤30mL/min/1.73m^(2)),以确定不同肾功能的差异。结果 糖尿病患者皮质RBF较健康对照组下降28%(P<0.05)。正常对照组和无明显蛋白尿的糖尿病患者之间的差异也有统计学意义(RB,EGFR,白蛋白/肌酐比均P>0.05)。随着糖尿病肾病(DN)的进展,CKD5个阶段RBF显著降低(P<0.05)。肾小球滤过率与肾血流量之间有很强的相关性(P<0.05)。结论ASL-MRI能够量化糖尿病患者早期肾脏血流灌注损伤,以及根据糖尿病肾病不同CKD分期的变化。此外,ASL定量的RBF和GFR之间存在相关性。Objective To evaluate the diagnostic value of arterial spin labeling(ASL)M RI in the diagnosis of renal hemodynamic impairment at different stages of diabetic(DM)chronic kidney disease(CKD).Methods Renal blood flow(RBF)was measured by 3T ASL-MRI in 91 subjects(46 healthy volunteers and 45patients with type 2 diabetes).Patients were assigned to groupⅠ(EGFR>60mL/min/1.73m^(2)),GroupⅡ(60≥EGFR>30mL/min/1.73m^(2))or groupⅢ(EGFR≦30mL/min/1.73m^(2))based on estimated glomerular filtration rate(EGFR)to determine differences in renal function.Results The cortical RBF of diabetic patients decreased by 28%compared with that of healthy control group(P<0.05).There was also a statistically significant difference between the normal control group and diabetic patients without significant proteinuria(RB,EGFR,albumin/creatinine ratio P>0.05).With the progression of diabetic nephropathy(DN),RBF in 5 CKD stages was significantly decreased(P<0.05).There was a strong correlation between glomerular filtration rate and renal blood flow(P<0.05).Conclusion ASL-MRI can quantify the early renal perfusion injury in diabetic patients and the change of CKD according to different stages of diabetic nephropathy.In addition,there was a correlation between RBF and GFR quantified by ASL.

关 键 词：动脉自旋标记MRI 糖尿病性肾病 血液动力学 肾小球滤过率 

分 类 号：R692[医药卫生—泌尿科学]