T1mapping与R2^(*) maps联合诊断慢性肾病

T1 mapping combined with R2^(*) maps for diagnosing chronic kidney disease

目的观察T1 mapping与R2^(*)maps联合诊断慢性肾病(CKD)的价值。方法纳入27例CKD患者,根据改善全球肾脏病预后组织CKD分期标准将其分为A组(轻度肾损害,n=16)和B组(中重度肾损害,n=11),另纳入20名健康成年人作为对照组(C组);观察其肾脏T2WI、T1 mapping及R2^(*)maps,比较3组间整体及两两间右肾皮、髓质T1值和R2^(*)值差异,行logistic回归分析,评估右肾皮髓质T1值、R2^(*)值和二者联合诊断CKD的效能。结果3组间右肾皮质T1值及R2^(*)值整体差异均有统计学意义(P均<0.05),而髓质T1值及R2^(*)值差异均无统计学意义(P均>0.05);B组皮质T1值显著高于A组和C组(P均<0.05),A组皮质R2^(*)值显著高于B组和C组(P均<0.05)。以右肾皮质T1值鉴别CKD轻度与中重度肾损害的曲线下面积(AUC)为0.77,鉴别CKD中重度肾损害与健康人的AUC为0.90;皮质R2^(*)值鉴别CKD轻度与中重度肾损害的AUC为0.94,鉴别CKD轻度肾损害与健康人的AUC为0.88;皮质T1值与R2^(*)值联合鉴别轻度CKD肾损害与中重度肾损害的AUC为0.97,与右肾皮质T1值的AUC差异有统计学意义(Z=2.14,P=0.033)。结论T1 mapping与R2^(*)maps联合有助于诊断CKD。

Objective To observe the value of T1 mapping combined with R2^(*) maps for diagnosing chronic kidney disease(CKD).Methods Totally 27 CKD patients were enrolled and divided into group A(mild renal damage,n=16)or B(moderate-severe renal damage,n=11)according to CKD staging criteria of Kidney Disease:Improving Global Outcomes.Meanwhile,20 healthy adults were enrolled(group C).T2WI,T1 mapping and R2^(*) maps of kidneys were acquired.T1 and R2^(*) values of renal cortex and medulla of the right kidney were measured and compared among 3 groups also between each 2 groups.Logistic regression analysis was performed,the efficacies of T1,R2^(*) values and the combination of renal cortex and medulla of the right kidney for diagnosing CKD were observed.Results There were significant differences of T1 and R2^(*) values of renal cortex among 3 groups(both P<0.05),but not of T1 nor R2^(*) values of renal medulla(both P>0.05).T1 value of renal cortex in group B was significantly higher than that in group A and group C(both P<0.05),and R2^(*) value of renal cortex in group A was significantly higher than that in group B and group C(both P<0.05).The area under the curve(AUC)of T1 value of renal cortex for differentiating CKD with mild or moderate-severe renal damage was 0.77,for differentiating CKD with moderate severe renal damage or healthy adults was 0.90.AUC of R2^(*) value of renal cortex for differentiating CKD with mild or moderate-severe renal damage was 0.94,for differentiating CKD with mild renal damage or healthy adults was 0.88.AUC of T1 value combined with R2^(*) value of renal cortex for differentiating CKD with mild or moderate severe renal damage was 0.97,significantly different from that of T1 value of renal cortex(Z=2.14,P=0.033).Conclusion T1 mapping combined with R2^(*) maps was helpful for diagnosing CKD.