论文部分内容阅读
目的探究IgA肾病(IgAN)患者磁共振弥散加权成像(DWI)测量值与其病理及肾功能的相关性。方法收集35例IgAN患者作为IgAN组,20例健康志愿者作为对照组,所有受试者均采用3.0T MRI扫描仪进行双侧肾脏DWI,测量肾脏皮质、髓质表观弥散系数(ADC)值。IgAN组采用99Tcm-DTPA闪烁扫描测定分肾的肾小球滤过率(GFR),并根据Lee氏评级系统及Katafuchi评分标准,对IgAN患者进行病理分级与评分。比较对照组与IgAN各亚组之间肾脏皮质、髓质ADC值的差异;分析IgAN组分肾皮髓质ADC值与其GFR值之间的关系;IgAN组右肾皮质、髓质ADC值与其病理积分之间的关系。结果对照组及IgAN各亚组的肾脏皮质ADC值均大于髓质(P<0.05),对照组与IgAN各亚组之间皮、髓质ADC值差异均有统计学意义(P<0.05),但IgANⅠ级组皮质ADC值与对照组之间差异无统计学意义(P>0.05)。IgAN组分肾皮、髓质ADC值与其GFR值均呈正相关(P<0.01);IgAN组的右肾皮、髓质ADC值与其病理积分均呈负相关(P<0.05)。结论 DWI可以反映皮、髓质各自的生理效能,在IgAN中的应用具有可行性,尤其对评价肾脏滤过功能及病理变化有一定的临床价值,但对早期病变缺乏敏感性。
Objective To investigate the relationship between diffusion weighted imaging (DWI) and pathological and renal function in patients with IgA nephropathy (IgAN). Methods 35 patients with IgAN were selected as IgAN group and 20 healthy volunteers as control group. All subjects were examined with 3.0T MRI scanner for bilateral renal DWI, and the apparent diffusion coefficient (ADC) of renal cortex and medulla was measured . IgAN group was measured by 99Tcm-DTPA scintigraphy kidney glomerular filtration rate (GFR), and according to Lee’s rating system and Katafuchi score, IgAN patients with pathological grade and score. The ADC value of renal cortex and medulla between control group and IgAN subgroup was compared. The relationship between ADC value of renal cortex and medulla of IgAN group and GFR value was analyzed. ADC value of right renal cortex and medulla in IgAN group was compared with that of IgAN group The relationship between points. Results The ADC value of renal cortex in the control group and IgAN subgroups was significantly higher than that in the medulla (P <0.05). There was significant difference in ADC value between the control group and the IgAN subgroups (P <0.05) However, there was no significant difference between the IgAN Ⅰ group and the control group (P> 0.05). The ADC values of IgAN and renal medulla were positively correlated with their GFR (P <0.01). The ADC values of right kidney and medulla of IgAN group were negatively correlated with their pathological scores (P <0.05). Conclusion DWI can reflect the physiological performance of the skin and medulla. It is feasible in IgAN, especially for the evaluation of renal filtration function and pathological changes, but it is not sensitive to early lesions.