| 王盼,李向南,郑鑫,胡小鹏,张琛,蒋涛,李敏.体素内不相干运动成像定量评估慢性移植肾功能不全[J].中国医学影像技术,2024,40(1):93~97 |
| 体素内不相干运动成像定量评估慢性移植肾功能不全 |
| Intravoxel incoherent motion for quantitative evaluating chronic allograft dysfunction |
| 投稿时间：2023-09-07 修订日期：2023-12-13 |
| DOI：10.13929/j.issn.1003-3289.2024.01.018 |
| 中文关键词: 肾移植 肾功能不全,慢性 磁共振成像 前瞻性研究 |
| 英文关键词:kidney transplantation renal insufficiency, chronic magnetic resonance imaging prospective studies |
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| 中文摘要: |
| 目的 观察弥散加权成像体素内不相干运动（IVIM）定量评估慢性移植肾功能不全（CAD）的价值。方法 前瞻性纳入104例CAD患者，根据估算肾功能受损程度分为CAD 1、2、3组（n=11、61、32）；另以36名健康志愿者为对照组。比较组间及组内肾皮、髓质IVIM参数真性弥散系数（D值）、微循环灌注弥散系数（D*值）及灌注分数（f值），评价IVIM参数诊断CAD的价值。结果 移植肾皮质D值在各CAD组均低于对照组（P均<0.05），且在1组、2组、3组依序减低（P均<0.05）；CAD 2组、3组移植肾髓质D值均低于对照组（P均<0.05）。各CAD组移植肾皮质D*值均低于对照组（P均<0.05），CAD 2组、3组肾髓质D*值均低于对照组（P均<0.05）。CAD 2组、3组移植肾皮质、髓质f值均低于对照组（P均<0.05），CAD 3组移植肾皮质f值低于1组及2组（P均<0.05）。各组肾皮质D值、D*值、f值均高于髓质（P均<0.05）。皮质IVIM联合模型诊断CAD的曲线下面积（AUC）为0.96，优于D*值及f值（AUC=0.74、0.83，P均<0.05）而与D值（AUC=0.94）差异无统计学意义（P=0.32）。髓质IVIM联合模型诊断CAD的AUC为0.91，优于D值、D*值及f值（AUC=0.80、0.67、0.80，P均<0.05）。结论 IVIM参数可定量评估CAD。 |
| 英文摘要: |
| Objective To observe the value of diffusion weighted imaging intravoxel incoherent motion (IVIM) for quantitative evaluating chronic allograft dysfunction (CAD). Methods Totally 104 CAD patients were prospectively enrolled and were assigned into CAD 1, 2 and 3 groups (n=11, 61, 32) based on impairment severity of estimated renal function, and 36 healthy volunteers were enrolled as control group. The true diffusion coefficient (D value), microcirculation perfusion diffusion coefficient (D* value) and perfusion score (f value) of renal cortex and medulla IVIM parameters were compared among groups and within groups to assess the value of IVIM parameters for diagnosing CAD. Results The D value of transplanted renal cortex in all CAD groups were lower than that in control group (all P<0.05), which decreased among CAD 1, 2 and 3 groups (all P<0.05). The D value of transplanted kidney medulla in CAD 2 and 3 groups were lower than that in control group (both P<0.05). The D* values of transplanted renal cortex in all CAD groups were lower than that in control group, while of renal medulla in CAD 2 and 3 groups were lower than that in control group (both P<0.05). The f values of cortex and medulla in CAD 2 and 3 groups were lower than those in control group (all P<0.05), while of cortex in CAD 3 group was lower than that in CAD 1 and 2 groups (both P<0.05). The area under the curve (AUC) of cortical IVIM combined model for diagnosing CAD was 0.96, better than the D* value and f value (AUC=0.74, 0.83, P<0.05) but not significantly different with that of the D value (AUC=0.94, P=0.32). AUC of medullary IVIM combined model for diagnosing CAD was 0.91, better than that of D, D* and f value (AUC=0.80, 0.67 and 0.80, all P<0.05). Conclusion IVIM parameters could be used to quantitatively evaluate CAD. |
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