MR T_(1)-mapping结合动脉自旋标记技术在评估儿童慢性肾脏病肾纤维化和灌注中的应用  

Application of MR T_(1)-mapping Combined with Arterial Spin Labeling Technique in Assessment of Kidney Fibrosis and Perfusion in Children with Chronic Kidney Disease

作　　者：赵佳佳[1] 胡俊[1] 尹传高 顾东浩 朱晓冬 ZHAO Jiajia;HU Jun;YIN Chuangao(Department of Imaging,Children’s Hospital of Anhui Medical University,The Fifth Clinical Medical College of Anhui Medical University,Hefei,Anhui Province 230051,P.R.China)

机构地区：[1]安徽医科大学附属省儿童医院、安徽医科大学第五临床医学院,合肥230051

出　　处：《临床放射学杂志》2025年第3期513-517,共5页Journal of Clinical Radiology

摘　　要：目的初步研究MR纵向弛豫时间定量成像(T 1-mapping)和动脉自旋标记技术(ASL)在诊断儿童慢性肾脏病(CKD)中的应用价值。方法纳入CKD患儿32例(包括肾脏未萎缩19例,萎缩13例),同期招募健康志愿者30名作对照组,行T 1-mapping和ASL序列扫描,分别获得肾皮质T 1值和肾皮质血流量(RBF)。比较对照组和CKD组患儿肾皮质T 1值和RBF值的差异,并分析CKD组肾皮质T 1值和RBF值与估算肾小球滤过率(eGFR)、血肌酐(Scr)、血胱抑素C(Cys-C)的相关性。结果CKD组较对照组肾皮质T 1值明显升高、RBF值明显减低(P<0.05);CKD组中,肾脏未萎缩患儿肾皮质T 1值与eGRF、Scr、Cys-C呈高、中度相关(r=-0.832、0.777、0.698,P<0.05),肾脏萎缩患儿肾皮质T 1值与eGRF、Scr呈高度相关(r=0.726、-0.743,P<0.05);CKD组肾皮质RBF与eGRF、Cys-C、Scr呈中度相关(r=0.699、-0.619、-0.554,P<0.05)。结论MR T_(1)-mapping和ASL定量反映肾脏微观病理变化及血流灌注情况,具有预测肾脏慢性病理损伤的潜在价值,有望在肾脏发生不可逆损伤前早期、无创地提供肾脏功能信息。Objective To preliminarily investigate the value of MR T_(1)-mapping and arterial spin labeling(ASL)in the diagnosis of pediatric chronic kidney disease(CKD).Methods Thirty-two children with CKD(including 19 without renal atrophy and 13 with renal atrophy)and 30 healthy volunteers underwent T 1-mapping and ASL examinations.T 1 values and renal cortical blood flow(RBF)were acquired.Differences in renal cortex T 1 values and RBF between the control and CKD groups were compared,and correlations between cortical T 1 values and RBF and the estimated glomerular filtration rate(eGFR),blood creatinine(Scr),and blood cystatin C(Cys-C)in the CKD group were analyzed.Results In the CKD group,the cortex T 1 value was significantly higher,and the cortex RBF value was significantly lower than in the control group(P<0.05).In the CKD group,the cortex T 1 value was highly and moderately correlated with eGFR,Scr,and Cys-C in children without renal atrophy(r=-0.832,0.777,0.698,P<0.05),and highly correlated with eGFR and Scr in children with renal atrophy(r=0.726,-0.743,P<0.05).In the CKD group,cortex RBF was moderately correlated with eGFR and highly correlated with Cys-C and Scr(r=0.699,-0.619,-0.554,P<0.05).Conclusion MR T_(1)-mapping and ASL can quantitatively assess renal microscopic pathological changes and blood perfusion,with potential value in predicting chronic renal injury.They are expected to provide kidney function information early and non-invasively before irreversible kidney damage occurs.

关 键 词：慢性肾脏病 儿童 T_(1)-mapping 动脉自旋标记 磁共振功能成像 

分 类 号：R726.9[医药卫生—儿科] R445.2[医药卫生—临床医学]