肾脏ADC值在儿童单侧先天性肾积水肾脏中的应用价值

Value of renal ADC in the kidney of children with unilateral congenital hydronephrosis

目的 探讨肾脏磁共振表观弥散系数（ADC）值对评价6岁以下先天性肾积水儿童肾脏水分子扩散功能的价值.方法 筛选80例6岁以下经手术证实存在肾盂输尿管连接部梗阻患儿作为研究对象,所有患儿均明确存在单侧先天性肾积水,另选取40例肾功能正常的儿童进行磁共振检查,首先按年龄分为≤1岁及1~6岁两组,将不同年龄组内不同程度肾积水患儿分为正常、轻-中度积水、重度积水及巨大积水四组,检验不同年龄组内不同程度积水肾脏及积水对侧肾脏ADC值间是否有差异.结果 ≤1岁患儿重度及巨大积水肾脏ADC值与正常肾脏ADC值间比较差异有统计学意义（P＜0.05）;1~6岁患儿巨大与重度肾积水间ADC值比较差异有统计学意义（P＜0.05）;两组均与正常肾脏ADC值比较差异有统计学意义,且ADC值随积水程度增加而增大.不同程度积水对侧肾脏ADC值与正常肾脏ADC值比较差异未见统计学意义（P＞0.05）.结论 肾脏磁共振检查DWI成像中,通过对肾脏ADC值的计算可明确先天性肾积水患儿肾脏水分子扩散功能的变化,为婴幼儿及学龄前儿童单侧先天性肾积水的量化诊断与治疗提供指导,具有临床研究及推广价值.

Objective To evaluate the value of apparent diffusion coefficient（ADC） value of renal magnetic resonance imaging in evaluating the function of molecular diffusion in the kidney of children under 6 years old.Methods Eighty children under 6 years old were selected as the study subjects, all the children had unilateral congenital hydronephrosis, magnetic resonance examination was performed in 40 children with normal renal function, the children were first, divided into two groups according to the age： less than 1 year old group and 1-6 years old group. The children were divided into normal, light-moderate hydronephrosis, severe hydronephrosis and huge hydronephrosis supgroup in different age groups, and then to examine whether there were differences in ADC values among the different degrees of unilateral hydronephrosis supgroups in different age groups.Results There was significant difference in the ADC value of severe, huge hydronephrosis and the ADC of the normal kidney in less than 1 year old children; ADC was significantly different between severe and huge hydronephrosis in 1-6 years old children（P〈0.05）; There were significant differences in ADC values between the two hydronephrosis groups and the normal control group, and the ADC value increased with the degree of hydronephrosis accumulation. There was no significant difference in the ADC value of contralateral kidney and the ADC value of the normal kidney among different degree of hydronephrosis（P〉0.05）.Conclusions The magnetic resonance imaging of the kidney is DWI, by calculating the ADC value of the kidney, can clear the change of the molecular diffusion function of the kidney in children with congenital hydronephrosis, to provide guidance for the quantitative diagnosis and treatment of unilateral congenital renal hydrocephalus in infants and preschool children.