摘要
目的：探讨体素内不相干运动（IVIM）及T1 mapping成像评估肾移植术后早期移植肾功能的价值。方法前瞻性收集行异体肾移植术后2～4周的62例患者和20名健康志愿者（对照组）行肾脏常规MRI、T1 mapping及IVIM成像。根据估算肾小球滤过率（eGFR）将肾移植患者分为移植肾功能良好组（37例）和移植肾功能受损组（25例）。分别测量皮质和髓质的ADC、单纯扩散系数（ADCslow）、微循环灌注系数（ADCfast）、灌注分数（f）及T1值。采用单因素方差分析比较不同组间肾脏皮、髓质间各参数值的差异，采用Pearson相关分析比较移植肾皮、髓质各参数值与eGFR间的相关性，采用ROC评价各参数值鉴别诊断两组移植肾的效能。结果除皮质T1值、ADCfast和髓质T1、f值外，移植肾功能良好组与对照组间各参数值差异无统计学意义（P〉0.05）。除髓质T1、ADCfast值外，移植肾功能受损组皮、髓质各参数值与功能良好组比较，差异有统计学意义（P〈0.05）。除髓质f、ADCfast值外，移植肾功能受损组皮、髓质各参数值与对照组比较，差异均有统计学意义（P〈0.05）。移植肾皮质T1值与eGFR呈弱负相关（r=－0.396，P＝0.001），皮质ADC、ADCslow、ADCfast、f值以及髓质ADC、ADCslow（r＝0.604，P〈0.01）与eGFR呈弱或中度正相关（r＝0.359～0.604，P〈0.05）。以皮质T1值=17.36×102 ms为截点鉴别移植肾功能受损的敏感度为91.9%；以皮质ADC值=1.98×10-3mm2/s为截点鉴别的特异度为96.0%。结论 IVIM及T1 mapping成像可用于无创评估及监测早期移植肾功能。
Objectives To investigate the ability of T1 mapping and intravoxel incoherent motion imaging （IVIM） parameters for evaluating renal allografts at the early stage after renal transplantation. Methods This prospective study protocol was approved by the local ethics committee, and written informed consent was obtained from all subjects. Sixty two recipients 2 to 4 weeks after kidney transplantation and 20 healthy volunteers （control group） underwent routine MRI, T1 mapping, and IVIM imaging （11 b values, 0 to 700 s/mm2）. Recipients were divided into two groups base on their estimated glomerular filtration rate （eGFR）：37 recipients with good allograft function （eGFR≥60 ml·min-1·1.73 m-2） and 25 recipients with impaired allograft function （eGFR〈60 ml·min-1·1.73 m-2）. The ADC, true diffusion coefficient （ADCslow）, pseudo-diffusion coefficient （ADCfast）, perfusion fraction （f） and T1 values were measured on both cortex and medulla. Differences among groups were compared using the one-way analysis of variance. Correlations between eGFR and the parameters in renal allografts were assessed by using Pearson correlation analysis. ROC was performed to assess the diagnostic utilities of using these parameters to＆amp;nbsp;discriminate allografts with impaired function from good function. Results Excepting for cortical T1, ADCfast and medullary T1, f values, allografts with good function showed no differences in other parameters compared with healthy control. Excepting for medullary T1 and ADCfast,the other values showed significantly differences in allografts with impaired function compared to allografts with good function （all P〈0.05）. Excepting for medullary f and ADCfast values, allografts with impaired function showed significantly differences in the parameters compared with good function group（all P〈0.05）. In renal allografts, excepting for medullary T1, ADCfast, and f values, cortical T1 exhibited a negative correlation with renal function, and there was a signif
作者
陈丽华
任涛
温成龙
谢双双
黄黎香
付迎欣
王振
尹建忠
沈文
Chen Lihua Ren Tao Wen Chenglong Xie Shuangshuang Huang Lixiang Fu Yingxin Wang Zhen Yin Jianzhong Shen Wen(Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2016年第10期762-767,共6页
Chinese Journal of Radiology
基金
2014年天津市卫生局科技基金（2014KY07）
2016年天津市自然科学基金（16JCYBJC27300）
关键词
肾移植
磁共振成像
肾机能不全
Kidney transplantation
Magnetic resonance imaging
Renal insufficiency
