| 徐红霞,卓丽华,黄小华,李宏伟,付国旭.MR扩散峰度成像评价急性胰腺炎肾损伤[J].中国医学影像技术,2021,37(4):562~567 |
| MR扩散峰度成像评价急性胰腺炎肾损伤 |
| MR diffusion kurtosis imaging for evaluation on kidney injury caused by acute pancreatitis |
| 投稿时间：2020-03-10 修订日期：2020-09-22 |
| DOI：10.13929/j.issn.1003-3289.2021.04.019 |
| 中文关键词: 胰腺炎 磁共振成像 扩散峰度成像 急性肾损伤 |
| 英文关键词:pancreatitis magnetic resonance imaging diffusion kurtosis imaging acute kidney injury |
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| 中文摘要: |
| 目的 评估MR扩散峰度成像（DKI）诊断急性胰腺炎（AP）肾损伤的价值。方法 对62例临床诊断AP患者（AP组）及23名健康志愿者（HC组）采集上腹部常规MRI及DKI。对AP组行MR严重指数（MRSI）评分，根据结果分为轻度AP （n=26）、中度AP （n=29）及重度AP （n=7）亚组。比较AP组与HC组间、AP组内不同亚组间双肾皮质及髓质各参数值，包括平均峰度（MK）、轴向峰度（Ka）、径向峰度（Kr）及衍生参数各向异性分数（FA）、平均扩散（MD）、轴向扩散（Da）及径向扩散（Dr）差异。绘制AP组与HC组间差异有统计学意义的参数诊断肾损伤的ROC曲线，并评价其诊断效能。结果 相比HC组，AP组皮质及髓质FA （Z=－4.13、－3.42）、Da （Z=－2.80、－3.11）降低，MK （Z=－2.34、－4.26）、Ka （Z=－3.21、3.63）及Kr （Z=－3.22、－4.67）升高（P均<0.01）。AP组内3亚组间肾皮质DKI参数除FA外差异均有统计学意义（P均<0.05）；肾髓质MD、Da、Dr及Ka差异有统计学意义（P均<0.05），其余DKI参数差异均无统计学意义（P均>0.05）。ROC曲线显示，根据髓质MK、Ka及Kr诊断AP肾损伤的AUC最高，均为0.64（P<0.01）。结论 DKI技术可早期发现及定量分析AP肾脏损伤。 |
| 英文摘要: |
| Objective To observe the diagnostic value of MR diffusion kurtosis imaging (DKI) for evaluating kidney injury caused by acute pancreatitis (AP). Methods Total 62 patients with clinical diagnosed AP (AP group) and 23 health volunteers (HC group) underwent upper abdominal routine MR examinations and DKI. Patients in AP group were scored with MR severity index (MRSI) and then divided into mild AP (n=26), moderate AP (n=29) and severe AP subgroups (n=7). The parameters of renal cortex and medulla were compared between groups and among different AP subgroups, respectively, including mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), fractional anisotropy (FA), mean diffusion (MD), axial diffusion (Da) and radial diffusion (Dr). Receiver operating characteristic (ROC) curve of parameters being statistically different between AP group and HC group were drawn, and the corresponding diagnostic efficacy were analyzed. Results Compared with HC group, FA (Z=-4.13, -3.42) and Da (Z=-2.80, -3.11) decreased, MK (Z=-2.34, -4.26), Ka (Z=-3.21, 3.63) and Kr (Z=-3.22, -4.67) increased in both renal cortex and medulla in AP group (all P<0.01). Statistical differences of DKI parameters except FA of the renal cortex, also of MD, Da, Dr and Ka of renal medulla among AP subgroups were found(all P<0.05). ROC curves showed that the highest AUCs of the medullary MK, Ka and Kr for diagnosing renal injury of AP were all 0.64 (all P<0.01). Conclusion DKI could be used to early detect and quantitatively analyze kidney injury caused by AP. |
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