MR弥散张量成像对儿童急性肾损伤的初步评估

Preliminary evaluation of MR diffusion tensor imaging in children with acute renal injury

目的初步探讨MR弥散张量成像对儿童急性肾损伤的诊断价值,进一步提高早期诊断急性肾损伤(AKI)的水平。方法收集湖南省儿童医院22例符合临床AKI诊断标准的患儿为观察组,同期收集23名健康儿童志愿者为对照组。检测所有受试儿的双肾皮质、髓质的各向异性分数(FA)、平均弥散系数(ADC)值,并收集AKI患儿同期血清肌酐值及病检结果;采用Spearman相关分析AKI患儿肾皮质、髓质ADC值和FA值与同期血清肌酐值的相关性。结果观察组患儿自身左、右肾皮质、髓质FA、ADC值分别比较,差异无统计学意义(P> 0. 05);对照组儿童自身左、右肾皮质、髓质FA、ADC值分别比较,差异无统计学意义(P> 0. 05)。AKI患儿髓质FA值、皮质FA、ADC值明显低于对照组儿童,差异均有统计学意义(P <0. 05),AKI患儿髓质ADC值与对照组儿童比较差异无统计学意义(P> 0. 05)。AKI患儿髓质FA值、皮质ADC值与同期血清肌酐值呈负相关(r=-0. 868、-0. 436,P <0. 05),皮质FA值,髓质ADC值与血清肌酐无相关性(P> 0. 05)。结论 DTI作为一种无创性核磁功能成像方法,可反映AKI早期肾功能损害,对临床诊断AKI具有潜在应用价值。

Objective To investigate the study of magnetic resonance(MR)diffusion tensor imaging in children with acute kidney injury,and further improve the clinical research level of early diagnosis of acute kidney injury(AKI).Methods Twenty-two children who met the clinical AKI diagnostic criteria were collected from the Childrens Hospital of Hunan Province.Twenty-three children volunteers were collected as the control group.The anisotropy fraction(FA)and mean diffusion coefficient(ADC)values of the renal cortex and medulla of all the tested children were detected,and the serum creatinine value and disease test results of children with AKI were collected.Spearman correlation analysis was used to analyze the correlation between the renal and medullary ADC values and FA values and serum creatinine values in the children with AKI.Results There were no significant differences in the FA,ADC values of left and right renal cortex and medulla of case group(P>0.05).There were no significant differences in the FA,ADC values of left and right renal cortex and medulla of control group(P>0.05).The medullary FA value,cortical FA and ADC value of the children with AKI were significantly lower than those of normal children(P<0.05).There was no significant difference in medullary ADC values between children with AKI and normal children(P>0.05).The medullary FA value and cortical ADC value of AKI patients were negatively correlated with serum creatinine value(r=-0.868,-0.436,P<0.05),and there was no correlation between cortical FA,medullary ADC and serum creatinine in the rest of the children.Conclusions As a non-invasive imaging method,diffusion tensor imaging(DTI)can reflect the early renal damage of AKI and has potential application value for clinical diagnosis of AKI.