MR扩散加权成像在肝硬化后肾功能评价中的应用

Application of MR Diffusion Weighted Imaging in the Evaluation of Renal Function after Liver Cirrhosis

目的:探讨慢性肾病患者利用MR扩散加权成像在肝硬化后肾功能评价中的应用价值。方法:本研究选取2015年3月~2016年5月就诊于我院的34例慢性肾病患者作为观察组,其中13例慢性肾病患者为肌酐正常组,21例慢性肾病患者为肌酐升高组;并选取同期的18例健康志愿者为对照组。测量并记录各组的ADC值,并分析ADC值和血清肌酐水平与肌酐清除率的相关性。结果:对照组在不同b值(弥散敏感梯度系数)下的ADC值分别为(316.42±10.05)×10^(-5)mm^2/s、(275.52±4.89)×10^(-5)mm^2/s。肌酐正常组在不同b值下的ADC值分别为(251.52±8.26)×10^(-5)mm^2/s、(217.44±21.85)×10^(-5)mm^2/s;肌酐升高组在不同b值下的ADC值分别为(280.87±5.22)×10^(-5)mm^2/s、(272.64±10.08)×10^(-5)mm^2/s;肌酐正常组、肌酐升高组患者在不同b值下的ADC值均明显低于对照组,比较差异均显著,具有统计学意义(P<0.05);肌酐升高组患者平均的血清肌酐水平达(827.48±698.36)μmol/L,肌酐升高组患者ADC值和血清肌酐的水平呈负相关,在不同b值下的ADC值比较差异不显著,无统计学意义(P>0.05);肌酐升高组患者平均的肌酐清除率达(15.41±14.53)mL/min,肌酐升高组患者ADC值和肌酐清除率呈弱正相关,在不同b值下的ADC值比较差异均显著,具有统计学意义(P<0.05)。结论:MR扩散加权成像是一种对肾脏的扩散加权成像与测量ADC值的无创且具有潜力的肾功能评价手段。

Purpose：To explore the role of MR diffusion weighted imaging in evaluating renal function after liver cirrhosis.Materials and Methods：34 cases of patients with chronic kidney disease who had received treatment in our hospital between March 2015 and May 2016 were selected as the observation group,among which 13 cases were set as normal creatinine group and 21 cases as increasing creatinine group; 18 healthy volunteers selected during the same period were taken as the control group.The ADC values in each group were measured and recorded,and the correlation between ADC value and serum creatinine level,and creatinine clearance rate was analyzed.Results：The ADC values under different b values（diffusion sensitive gradient coefficient） were（316.42 ± 10.05） × 10-5mm2/s and（275.52 ± 4.89） × 10-5mm2/s.ADC values under different b values in the normal creatinine group were respectively（251.52 ± 8.26） × 10-5mm2/s and（217.44 ± 21.85） × 10-5mm2/s; ADC values in increasing creatinine group under different b values were（280.87 ± 5.22） × 10-5mm2/s and（272.64 ± 10.08） × 10-5mm2/s; ADC values under different b values in the normal creatinine group and increasing creatinine group were both significantly lower than that in the control group,and the difference was statistically significant（P〈0.05）; average serum creatinine level in the increasing creatinine group was（827.48 ± 698.36） μmol/L,and the ADC values were negatively correlated with the level of serum creatinine,and the difference in ADC values under different b values showed no statistically significant difference（P〉0.05）; average creatinine clearance rate in the increasing creatinine group was（15.41 ± 14.53） mL/min,and the ADC value was somewhat positively correlated with the creatinine clearance rate,and the difference in ADC under different b values were statistically significant（P〈0.05）.Conclusion：MR diffusion weighted imaging（DWI） is a non-invasive and promisingrenal function evaluation method for the diffusion weighted imaging of kidney and the measurement of ADC values.