基于四维血流MRI的腹主动脉血流动力学指标与慢性肾病患者肾功能的相关性研究  

Association study on abdominal aortic hemodynamic parameters based on four-dimensional flow MRI with renal function in chronic kidney disease

作　　者：宗钦伶 潘靓[2] 周华[3] 蒋振兴[2] 丁玖乐[2] 沈楠[2] 陈杰[2] 邢伟[2] Zong Qinling;Pan Liang;Zhou Hua;Jiang Zhenxing;Ding Jiule;Shen Nan;Chen Jie;Xing Wei(Medical College of Yangzhou University,Yangzhou 225001,China;Department of Radiology,First People′s Hospital of Changzhou,Changzhou 213003,China;Department of Nephrology,First People′s Hospital of Changzhou,Changzhou 213003,China;Department of Radiology,the People's Hospital of Pengzhou,Pengzhou 611930,China)

机构地区：[1]扬州大学医学院,扬州225001 [2]常州市第一人民医院放射科,常州213003 [3]常州市第一人民医院肾内科,常州213003 [4]彭州市人民医院放射科,彭州611930

出　　处：《中华放射学杂志》2025年第2期212-217,共6页Chinese Journal of Radiology

基　　金：国家自然科学基金(82001763、82302141、82471966);江苏省自然科学基金(BK20241776);常州市科技计划项目(CJ20244015);南京医科大学常州医学中心重点项目(CMCM202301)。

摘　　要：目的:探讨慢性肾病(CKD)患者肾功能与腹主动脉四维血流(4D Flow)MRI血流动力学指标之间的相关性。方法:该研究为横断面研究,前瞻性纳入2021年3月至2023年5月常州市第一人民医院临床诊断为CKD的73例患者及同期无肾功能损伤的13例志愿者。根据估算肾小球滤过率(eGFR)分为CKD 1~3期组(34例)、CKD 4~5期组(39例)、对照组(13例)。所有受试者均行腹主动脉4D Flow MRI检查,测量腹主动脉脉搏波速度(PWV)、腹主动脉近端(Plane_1)及较高一侧肾动脉开口水平(Plane_2)的峰值流速和最大壁剪切应力(WSS)。采用单因素方差分析或Kruskal-Wallis检验比较3组间4D Flow MRI血流动力学指标的差异,采用Spearman相关系数分析腹主动脉4D Flow MRI血流动力学指标与eGFR的相关性,采用多因素线性回归分析eGFR的独立影响因素。结果:3组间腹主动脉PWV、Plane_1最大WSS、Plane_2最大WSS的差异有统计学意义(H=10.38,P=0.006;F=11.16,P<0.001;F=4.75,P=0.011)。Plane_1峰值流速、Plane_2峰值流速的差异无统计学意义(P均>0.05)。腹主动脉PWV与eGFR呈负相关(r_(s)=-0.30,P=0.005),Plane_1最大WSS、Plane_2最大WSS与eGFR呈正相关(r_(s)=0.39,P<0.001;r_(s)=0.29,P=0.006)。腹主动脉PWV、Plane_1最大WSS是eGFR的独立影响因素(偏回归系数b=-4.32,P=0.018;b=132.23,P=0.004)。结论:腹主动脉4D Flow MRI血流动力学指标与CKD患者的肾功能具有相关性,腹主动脉PWV、Plane_1最大WSS是eGFR的独立影响因素。Objective To explore the correlation between renal function and abdominal aortic hemodynamic parameters based on four-dimensional flow(4D Flow)MRI in patients with chronic kidney disease(CKD).Methods A cross-section prospective study was conducted on 73 patients diagnosed with CKD at First People′s Hospital of Changzhou between March 2021 and May 2023,as well as 13 volunteers without kidney injury.According to the estimated glomerular filtration rate(eGFR),the subjects were divided into CKD 1-3 stage group(n=34),CKD 4-5 stage group(n=39),and control group(n=13).All subjects underwent 4D Flow MRI examination of the abdominal aorta,measuring pulse wave velocity(PWV),peak velocity,and maximum wall shear_(s)tress(WSS)at the proximal plane(Plane_1)and the higher renal artery opening plane(Plane_2)of the abdominal aorta.The differences in 4D Flow MRI hemodynamic parameters among the three groups were compared using a one-way analysis of variance or the Kruskal-Wallis test.The correlation between 4D Flow MRI hemodynamic parameters and eGFR was analyzed by using the Spearman correlation coefficient.The independent influencing factors that affect eGFR were analyzed by using multivariate linear regression analysis.Results There were significant differences in abdominal aortic PWV and maximal WSS of Plane_1 and Plane_2 among the three groups(H=10.38,P=0.006;F=11.16,P<0.001;F=4.75,P=0.011).There were no significant differences in the peak velocity of Plane_1 and Plane_2 among the three groups(both P>0.05).Abdominal aortic PWV was negatively correlated with eGFR(r_(s)=-0.30,P=0.005).There was a positive correlation between the maximal WSS of Plane_1 and Plane_2 with eGFR(r_(s)=0.39,P<0.001;r_(s)=0.29,P=0.006).Abdominal aortic PWV and maximal WSS of Plane_1 were independent influencing factors of eGFR(b=-4.32,P=0.018;b=132.23,P=0.004).Conclusions There is an independent correlation between renal function and abdominal aortic hemodynamic parameters based on 4D Flow MRI in patients with CKD,and abdominal aortic PWV and maximal

关 键 词：磁共振成像 四维血流 慢性肾病 腹主动脉 动脉顺应性 血流动力学 

分 类 号：R73[医药卫生—肿瘤]