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目的探讨肾脏皮质体素内不相干运动磁共振扩散加权成像(IVIM-DWI)在慢性肾脏病(CKD)肾功能评估中的应用价值。方法共85例临床诊断为CKD的患者纳入本研究,所有患者均在3.0 T磁共振成像仪行肾脏斜冠状位IVIM-DWI(10个b值)检查。按照简化肾脏病膳食改良(MDRD)公式来计算估算肾小球滤过率(eGFR),根据所得eGFR,参照慢性肾脏病分期将患者分为3组:即eGFR<30 ml/min/1.73 m~2(第1组)、30≤eGFR<60 ml/min/1.73m~2(第2组)、eGFR≥60 ml/min/1.73m~2(第3组);分别测量计算各组肾脏皮质表观扩散系数(ADC),单纯水分子扩散系数(D_(slow)),微循环灌注系数(D_(fast))、灌注分数(PF)。比较3组各参数的差异,并分析与eGFR的相关性。结果慢性肾脏病患者肾皮质ADC、D_(slow)、D_(fast)数据满足正态分布;ADC、D_(slow)、D_(fast)、PF不同组间指标值均存在显著差异(1组<2组<3组,P<0.05);ADC、D_(slow)、D_(fast)、PF均与eGFR存在线性相关性(r皮=0.620、0.628、0.575、0.619,P<0.05)。结论 IVIM-DWI作为无创性的检查技术,用于肾脏皮质微观结构观察和功能的测量,其参数值在一定程度上能反映肾小球滤过功能。
Objective To investigate the value of non-coherent mobile magnetic resonance diffusion weighted imaging (IVIM-DWI) in the assessment of renal function in patients with chronic kidney disease (CKD). METHODS: A total of 85 patients with clinically diagnosed CKD were enrolled in this study. All patients underwent IVIM-DWI (10 b values) in the oblique coronal coronaries at 3.0 T magnetic resonance imaging. The estimated glomerular filtration rate (eGFR) was calculated according to the simplified kidney disease diet modification (MDRD) formula, and the patients were divided into 3 groups according to the eGFR obtained and the chronic kidney disease staging: eGFR <30 ml / min / 1.73 m ~ (Group 1), 30≤eGFR <60 ml / min / 1.73m ~ 2 (group 2) and eGFR≥60 ml / min / 1.73m ~ 2 Apparent diffusion coefficient (ADC), simple water diffusion coefficient (D slow), microcirculation perfusion coefficient (D fast), perfusion score (PF). The differences among the three groups were compared and the correlation with eGFR was analyzed. Results The data of ADC, D slow and D fast in renal cortex of patients with chronic kidney disease were normal distribution. There were significant differences among ADC, D slow, There were linear correlation between ADC, D slow, fast and PF and eGFR (r = 0.620,0.628,0.575,0.619, P <0.05). Conclusion IVIM-DWI is a noninvasive technique used to observe the microstructure and function of renal cortex. The parameters of IVIM-DWI can reflect glomerular filtration function to a certain extent.