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·1.73m^2),11例]和中重度DKD亚组[eGFR<60ml/(min·1.73m^2),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/(100g·min)]、轻度DKD亚组[(242.86±56.86)ml/(100g·min)]、中重度DKD亚组[(173.39±27.16)ml/(100g·min)]及正常对照组[(269.71±33.28)ml/(100g·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。
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≥60ml/[min·1.73m^2]）and moderate-severe disease subgroup（n=14,eGFR〈60 ml/[min·1.73m^2]）.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/[100g·min]）,SD group（[258.52±42.30]ml/[100g·min]）,mild disease group（[242.86±56.86]ml/[100g·min]）and moderate-severe disease group（[173.39±27.16]ml/[100g·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.
出处
《中国医学影像技术》
CSCD
北大核心
2017年第5期747-751,共5页
Chinese Journal of Medical Imaging Technology
基金
国家自然科学基金(81471647)
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
Diabetes mellitus
type 2
Diabetes complications
Magnetic resonance imaging
Arterial spin labeling
