MR扩散加权成像在慢性肾病肾功能损害方面的价值研究

Evaluation of Diffusion-Weighted MR Imaging in Renal Function of Patients with Chronic Kidney Disease

目的探讨MR扩散加权成像(DWI)在评价慢性肾病(CKD)肾功能损害方面的价值。资料与方法 CKD患者及正常对照组各57例,采用b值500 s/mm2在屏气情况下进行肾脏冠状面DWI。所有患者及正常对照组均收集血清肌酐水平(SCr)等实验室检查结果。比较病例组与正常对照组肾脏表观扩散系数(ADC)值,并分析患者肾脏ADC值与SCr、肾小球滤过率(GFR)间的相关性。结果 CKD组肾脏ADC值显著低于正常对照组(t=4.466,P<0.01)。病例组双肾间无显著统计学差异。正常对照组与CKD1期患者肾脏ADC值间无显著统计学差异,但与CKD2～5期间具有显著差异(P<0.05)。病例组肾脏ADC值与SCr间呈显著负相关关系(r=-0.449,P=0.001)。病例组肾脏ADC值与肾脏核医学GFR间存在正相关关系(r=0.426,P=0.011)。结论 DWI不但有助于CKD早期肾功能损害的诊断,对于CKD的分期也有一定的价值。

Objective To evaluate the feasibility of diffusion-weighted MR imaging to assess the renal function of patients with chronic kidney disease（CKD）.Materials and Methods 57 patients of CKDs and 57 volunteers were involved and received coronal fat-saturated echo-planar DW MR imaging with a single breath-hold time（b 500 sec/mm2）.The serum creatine（SCr） level and glomerular nitration rate（GFR） were collected.The ADCs were compared between patients and volunteers age-and sex-matched.The relationships between SCr,GFR level and ADCs were evaluated.Results Patients with CKD had significantly lower renal ADC than that of volunteers（t=4.466,P0.01.There was no significant difference in the ADC values between right and left kidneys in patients of CKDs（P0.05）.The ADC values of kidneys were significantly lower than the normal in most stages of CKD except stage 1 of CKD.There were negative correlation between the ADCs and SCr level（r=-0.449,P=0.001）,and positive correlation between the ADCs and GFR level（r=0.426,P=0.011） in the patients with CKD.Conclusion DW MR imaging is useful in the assessment of renal function,especially in the detection of early stage renal failure of CKD,and also is helpful in clinic staging of CKDs.