梗阻性肾病的磁共振肾功能成像

Obstructive nephropathy: MRI functional imaging of kidney

目的：通过对Ｔ１ＷＩ图像肾皮质－髓质分界（ＣＭＤ）的观测和应用磁共振肾灌注成像对肾功能损害进行测定。材料与方法： ４６例用重Ｔ２ＷＩ ＦＡＳＥ序列作磁共振尿路造影（ＭＲＵ）的患者。在Ｔ１ＷＩ图像上，对肾皮质－髓质分界（ＣＭＤ）进行观测。应用平面回波成像技术（ＥＰＩ）对１２例进行磁共振肾灌注成像，测定肾功能损害。结果：正常肾皮质－髓质分界（ＣＭＤ）消失０／４６例，病肾ＣＭＤ消失４３／４６例，经Ｘ２检验，有显著差异（Ｐ＜０．００５）。肾灌注曲线呈反抛物线形，正常两侧的肾灌注曲线几乎是重叠的。病肾与正常肾肾灌注曲线相比，波始时间、达波谷时间均延长，经ｔ检验，有显著差异（Ｐｔｏ．００１），并且病肾的波幅小于正常肾。结论：对肾皮质－髓质分界（ＣＭＤ）的观测，可反映肾功能损害。应用平面回波成像技术（ＥＰＩ），进行肾灌注成像，可进一步评价肾功能。

Objective: According to the observation of CMD in T1WI, the renal function of the diseased side were determined in 12 cases using MR perfusion imaging. Malterials and Methods: Forty - six patients with hydronephrosis were examined with heavy T2WI FASE, we observed CMD on T1WI imaging in these 46 patients and evaluated the function of the damaged kidney in 12 cases using EPI. Results: There were distinct differences between the normal kidneys and the affected ones (P<0.005). No abnormability was found in the intact kidneys and CMD disappeared in 43 of 46 cases of the affected kidneys. The curve of kidney perfusion was contra- parabola and bilateral curves were almost overlap in the normal person. But in the affected kidneys, the time of beginning and to - peak-time was longer(P<0. 001 ) and the amplitude was shorter than the normal ones. Conclusions: According to the observation of CMD, it can show the degree of the damage in kidney function. Furthermore, we could evaluate the function of the affected kidney by using EPI.