时间-空间标记反转脉冲技术在慢性肾脏病分期中的初步研究

A Preliminary Study of Time Spatial Labeling Inversion Pulse Technology in the Staging of Chronic Kidney Disease

目的探讨时间-空间标记反转脉冲（Time-SLIP）技术在慢性肾脏病（CKD）分期中的评估价值。方法选择临床确诊的31例CKD患者[CKD1期（5例）,CKD2期（6例）,CKD3期（8例）,CKD4期（6例）和CKD5期（6例）]及13例健康志愿者（正常对照组）,均接受常规MRI检查和冠状位Time-SLIP肾动脉扫描,扫描后将原始数据进行最大密度投影（MIP）,由2位经验丰富的MRI医师对各组肾动脉分支的显示情况进行评价和统计学分析,并与CKD分期进行相关性研究。结果 CKD组与正常对照组比较：CKD1期与正常对照组之间肾动脉分支显示无统计学差异（P〉0.05）,CKD2~5期与正常对照组之间肾动脉分支显示存在统计学差异（P〈0.05）。CKD各组间比较：CKD1期与CKD2期肾动脉分支显示无统计学差异（P〉0.05）,其余各组间肾动脉分支显示均存在统计学差异（P〈0.05）,肾动脉分支显示与CKD分期呈中高度相关（P〈0.01）,肾动脉分支评分与血肌酐（SCr）呈显著负相关（P〈0.01）,与肾小球滤过率（GFR）呈显著正相关（P〈0.01）。结论利用Time-SLIP技术进行肾动脉成像对CKD分期具有一定的价值,可作为临床评价肾功能的一种无创检查手段。

Objective To explore the diagnostic value of time spatial labeling inversion pulse（TimeSLIP） technology in the staging of chronic kidney disease（CKD）. Methods 31 patients clinically diagnosed with CKD（including 5 patients with stage 1 CKD, 6 patients with phase 2 CKD, 8 patients with stage 3 CKD, 6 patients with stage 4 CKD and 6 patients with stage 5 CKD） as well as 13 healthy volunteers（normal control group） were included. All subjects received conventional MRI and renal artery examination with the coronal Time-SLIP technology. Two experienced radiologists assessed the branches of renal artery MR angiography on 3D-MIP reconstructed images, and studied the correlation with staging of CKD. Results Compared with CKD group and normal control group, there were no statistically significant differences in the branches shows of renal arteries between stage 1 CKD and normal control group（P〈0.05）,the differences were significant betuseen stage 2~5 CKD and noumal control group. Compared with each CKD group, there were no statistically significant differences in the branches shows of renal arteries between phase CKD1 and CKD2, there were statistically significant differences between other groups（P〈0.05）. There was an obvious correlation between the branches shows of renal arteries and the staging of CKD（P〈0.01）. There was a significant negative correlation with the branches shows of renal arteries and SCr（P〈0.01）, and a significant positive correlation with the GFR（P〈0.01）. Conclusion Using time-SLIP technology for renal artery has certain value in the staging of CKD. It can be used as a noninvasive clinical evaluation of renal function tests.