基于MRI-DKI分析IgA肾病早期肾脏损害与肾功能的相关性

Correlation between renal damage and renal function in early stage of IgA nephropathy based on MRI-DKI analysis

目的探讨基于磁共振扩散峰度成像(MRI-DKI)分析免疫球蛋白A(IgA)肾病早期肾脏损害与肾功能的相关性.方法选取2021年1月-2023年1月南京医科大学附属无锡人民医院收治的114例IgA肾病患者作为研究组.另选取同期的114例健康体检者作为对照组,比较MRI-DKI检验结果在肾病早期肾脏损害与肾功能的相关性中的效果.结果研究组肾皮质ADC值与肾髓质ADC值低于对照组(P<0.05),研究组肾皮质、肾髓质MD值低于对照组(P<0.05);研究组肾皮质、肾髓质MK值高于对照组(P<0.05);以髓质MD值的ROC下面积最大(0.850);当髓质MK值的截断值为0.620时鉴别诊断特异度最高,为100.00%;皮质MD的截断值为2.70×10^(-3)mm^(2)/s或髓质MD的截断值为2.22×10^(-3)mm^(2)/s时鉴别诊断的敏感度最高,为71.26%.IgA肾病患者肾皮质、肾髓质ADC值与GFR呈正相关(r=0.78、0.79,P<0.05);肾皮质、肾髓质MD值与GFR呈正相关(r=0.59、0.27,P<0.05);肾皮质、肾髓质MK值与GFR呈负相关(r=-0.36、-0.28,P<0.05).结论MRI-DKI可以反映肾皮、髓质各自的生理效能,在IgA肾病中具有临床价值,IgA肾病患者早期肾脏损害与肾功能指标GFR具有相关性.

Objective To investigate the correlation between early renal damage and renal function in immunoglobulin A(IgA)nephropathy based on magnetic resonance diffusion kurtosis imaging(MRI-DKI)analysis.Methods 114 patients with IgA nephropathy admitted to the hospital from January 2021 to January 2023 were selected as the study group.Another 114 healthy physical examiners from the same period were selected as the control group to compare the effect of MRI-DKI test results in the correlation between renal damage and renal function in the early stage of nephropathy.Results The renal cortical ADC values and renal medullary ADC values in the study group were lower than those in the control group(P<0.05),and the renal cortical and medullary MD values in the study group were lower than those in the control group(P<0.05);the renal cortical and medullary MK values in the study group were higher than those in the control group(P<0.05);the renal cortical and medullary ADC values in patients with IgA nephropathy were positively correlated with GFR(r=0.78,0.79,P<0.05);renal cortical and renal medullary MD values were positively correlated with GFR(r=0.59,0.27,P<0.05);renal cortical and renal medullary MK values were negatively correlated with GFR(r=-0.36,-0.28,P<0.05).Conclusion MRI-DKI can reflect the respective physiological efficacy of renal cortex and medulla,and has clinical value in IgA nephropathy,and early renal damage in patients with IgA nephropathy is correlated with the renal function index GFR.