血氧水平依赖MRI评估慢性肾病的应用价值

Application of blood oxygenation level-dependent MRI in evaluating chronic kidney disease

目的探讨血氧水平依赖MRI(BOLD-MRI)评估慢性肾病(CKD)的应用价值。方法对31例CKD患者(A组)和12例健康志愿者(C组)进行肾脏BOLD-MRI扫描,分别测量皮质和髓质R2*值,并绘制受试者工作特征(ROC)曲线评价诊断效能。结果 A组和C组皮质R2*值均低于髓质[(30.17±1.93)/s vs.(35.55±3.36)/s和(16.66±0.87)/s vs.(19.80±2.23)/s](P<0.01)。A组皮、髓质R2*值均高于C组(P<0.01)。A组皮质R2*值ROC曲线下面积(AUC)为0.90;取诊断阈值17.97/s时,其诊断CKD的敏感度和特异度分别为70.97%和100%;髓质R2*值的AUC为0.91,取诊断阈值33.19/s时,其敏感度和特异度分别为80.65%和100%。结论 BOLD-MRI可用以评估CKD患者的肾脏功能损伤。

Objective To explore the application value of blood oxygenation level-dependent MRI（BOLD-MRI）in evaluating chronic kidney disease（CKD）.Methods BOLD-MRI scanning of the kidney was performed in 31 patients with CKD（group A）and 12 healthy volunteers（group C）.The R2＊values of renal cortex and medulla were measured and receiver-operating characteristic（ROC）curve was drawn to assess diagnostic efficiency.Results The R2＊value of renal cortex was lower than that of renal medulla in groups of A and C[（30.17±1.93）/s vs.（35.55±3.36）/s and（16.66±0.87）/s vs.（19.80±2.23）/s]（P〈0.01）.The R2＊values of renal cortex and medulla in group A were higher than those in group C（P〈0.01）.The area under ROC curve for renal cortex R2＊value in group A was 0.90.Taking 17.97/s as a cutoff value,the sensitivity and specificity were 70.97% and 100%,respectively.While the area under ROC curve for renal medulla R2＊ value in group B was0.91.Taking 33.19/s as a cutoff value,the sensitivity and specificity were 80.65%and 100%respectively.Conclusion BOLD-MRI has a potential clinical value in assessing chronic renal injury of CKD patients.