磁共振扩散加权成像检测值与肾间质纤维化程度相关关系的研究

Relationship Between Renal Apparent Diffusion Coefficient and Renal Interstitial Fibrosis:Preliminary Study

目的采用3.0T磁共振机,探讨磁共振扩散加权成像(diffusion-weighted imaging,DWI)检测值与肾间质纤维化程度的相关性。方法对照组(48例正常志愿者)和慢性肾病组(24例慢性肾脏疾病患者)在肾脏常规MR扫描后行DWI扫描。慢性肾病组14例行穿刺活检,根据病理结果将肾小管间质损害程度分为、级;另10例肾脏体积缩小的慢性肾功能衰竭尿毒症期患者定为级。结果慢性肾病组级和级间质纤维化肾脏皮质表观弥散系数(ADC)值与对照组有差异(P<0.05),级间质纤维化肾脏髓质ADC值与对照组有差异(P<0.05)。随着间质纤维化等级增高,肾脏皮质和髓质ADC值有减小的趋势(P<0.05)。结论皮质ADC值一定程度上能反映肾脏间质纤维化程度。

Objective To explore the relationship between renal ADCs （apparent diffusion coefficient values ） and renal interstitial fibrosis （RIF） grades. Methods Twenty four patients with chronic renal diseases and 48 healthy volunteers （control group） were examined with SS-EPI DWI at 3.0T MR. In chronic renal disease group, RIF of 14 patients who received renal biopsy was determined as grade Ⅰ and Ⅱ based on the tubuleinterstitial damage degree, while RIF of 10 patients with uremia, who did not receive biopsy but had nephrogenic renal atrophy, was categorized as grade Ⅲ. Results With comparison of the study group and control group, ADCs of renal cortex were significantly different. In either grade Ⅱ or Ⅲ RIF, and ADCs of renal medulla showed difference in grade Ⅲ RIF（P〈0. 05）. Also, ADCs of both cortex and medulla displayed a decreasing trend as RIF grade increased （P〈0. 05）. Conclusion ADCs of renal cortex and medulla may reflect the grades of RIF. ADC of renal cortex might be more sensitive than that of renal medulla.