| 刘波,梁明龙,张久权,谢兵,潘航,左盼莉,王健.动脉自旋标记MRI评估2型糖尿病患者肾皮质灌注水平[J].中国医学影像技术,2017,33(5):747~751 |
| 动脉自旋标记MRI评估2型糖尿病患者肾皮质灌注水平 |
| Assessment of renal cortex blood flow with arterial spin labeling MRI in patients with type 2 diabetes |
| 投稿时间：2016-08-24 修订日期：2017-03-09 |
| DOI：10.13929/j.1003-3289.201608105 |
| 中文关键词: 糖尿病,2型 糖尿病并发症 磁共振成像 动脉自旋标记 |
| 英文关键词:Diabetes mellitus, type 2 Diabetes complications Magnetic resonance imaging Arterial spin labeling |
| 基金项目:国家自然科学基金（81471647）。 |
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| 中文摘要: |
| 目的 探讨应用动脉自旋标记（ASL）MRI评价2型糖尿病患者肾皮质灌注水平的价值。方法 前瞻性收集50例2型糖尿病患者，根据是否患糖尿病肾病（DKD）分为单纯糖尿病（SD）组（25例）和DKD组（25例）。依据估算肾小球滤过率（eGFR）将DKD组分为轻度DKD亚组[eGFR≥60 ml/（min·1.73m2），11例]和中重度DKD亚组[eGFR<60 ml/（min·1.73m2），14例]。同期选取25名年龄和性别相匹配的健康志愿者作为正常对照组。对所有受试者均行ASL MR扫描。由2名医师测量双肾皮质血流量（RBF），分析2名医师测量结果的一致性，比较各组间肾皮质RBF值的差异，并评价糖尿病患者肾皮质RBF与eGFR的相关性。结果 2名医师对肾皮质RBF值测量结果的一致性较高（ICC均>0.90）。SD组[（258.52±42.30）ml/（100 g·min）]、轻度DKD亚组[（242.86±56.86）ml/（100 g·min）]、中重度DKD亚组[（173.39±27.16）ml/（100 g·min）]及正常对照组[（269.71±33.28）ml/（100 g·min）]间肾皮质RBF值差异有统计学意义（F=20.66，P<0.01）；两两比较显示，中重度DKD亚组肾皮质RBF值明显低于其他3组（P均<0.01），轻度DKD亚组、SD组与正常对照组肾皮质RBF值差异无统计学意义（P=0.064、0.320）。2型糖尿病患者肾皮质RBF值与eGFR值呈正相关（r=0.646，P<0.001）。结论 ASL MRI可用于定量评估糖尿病患者的肾皮质灌注水平，RBF值可作为判断2型糖尿病患者肾功能的影像学指标。（ASL）MRI评价2型糖尿病患者肾皮质灌注水平的价值。 |
| 英文摘要: |
| Objective To investigate the value of arterial spin labeling (ASL) MRI in evaluation of renal cortex perfusion in patients with type 2 diabetes. Methods Fifty patients with type 2 diabetes were enrolled and divided into simple diabetes (SD) group (n=25) and diabetes kidney disease (DKD) group (n=25) according to suffering from DKD or not. Based on estimated glomerular filtration rate (eGFR), DKD group were further divided into mild disease subgroup (n=11, eGFR≥60 ml/[min·1.73m2]) and moderate-severe disease subgroup (n=14, eGFR<60 ml/[min·1.73m2]). Twenty-five healthy volunteers were recruited as control group at the same time. ASL MRI were performed on all participants. The cortical renal blood flow (RBF) of bilateral kidneys were measured by 2 radiologists. The consistency between 2 radiologists was analyzed. Statistical analysis were conducted to analysis the differences in cortical RBF among different groups. Correlation analysis were performed to evaluate the relationship between RBF and eGFR in type 2 diabetes patients. Results Cortical RBF values measured by two radiologists showed high consistency (all ICC>0.90). There was significant difference in cortical RBF among control group ([269.71±33.28]ml/[100 g·min]), SD group ([258.52±42.30]ml/[100 g·min]), mild disease group ([242.86±56.86]ml/[100 g·min]) and moderate-severe disease group ([173.39±27.16]ml/[100 g·min]; F=20.66, P<0.01). Moreover, the RBF in moderate-severe disease group was significantly lower than those in other groups (all P<0.01). And no significant differences of RBF was found among the remainder groups (P=0.064, 0.320). RBF in type 2 diabetes patients was positively correlated to eGFR (r=0.646, P<0.001). Conclusion ASL MRI is a valuable tool to quantitatively assess the renal perfusion in patients with type 2 diabetes mellitus, which can provide potential imaging indicator as RBF for the functional evaluation of kidney. |
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