摘要
目的:探讨磁共振T_(1)-mapping成像评估慢性肾脏病(CKD)肾功能损伤的应用价值。方法:招募60例CKD患者和20例健康志愿者(对照组)。检测CKD患者的血清肌酐值并计算估算肾小球滤过率(eGFR)。将CKD患者分为两组,轻度肾损伤组[eGFR≥60 mL/(min·1.73m^(2))]31例和中重度肾损伤组[eGFR<60 mL/(min·1.73 m^(2))]29例。所有受试者行双肾T_(1)-mapping检查,测量肾皮质和肾髓质的T_(1)值。采用配对样本t检验分析各组中肾皮质与肾髓质T_(1)值的差异,3组之间肾皮质和肾髓质T_(1)值的比较采用单因素方差分析,CKD组肾皮质和肾髓质T_(1)值与eGFR之间的相关性评估采用Spearman相关性分析,采用ROC曲线评估肾皮质和髓质T_(1)值评估肾功能损伤程度的诊断效能。结果:对照组、轻度肾损伤组及中重度肾损伤组中肾髓质的T_(1)值均明显高于肾皮质T_(1)值(P均<0.05)。三组之间肾皮质和肾髓质T_(1)值的差异均有统计学意义(P<0.01)。CKD患者eGFR与肾皮质T_(1)值呈高度负相关(r=-0.773,P<0.01),与肾髓质T_(1)值呈中度负相关(r=-0.689,P<0.01)。鉴别对照组与轻度肾损伤时,肾髓质T_(1)值的ROC曲线下面积大于肾皮质T_(1)值(0.866 vs.0.821);肾髓质T_(1)值的截断值为1505.2 ms时,敏感度和特异度分别为83.9%和80.0%。鉴别中重度与轻度肾损伤时,肾皮质T_(1)值的ROC曲线下面积大于肾髓质T_(1)值(0.874 vs.0.820);当肾皮质T_(1)值的截断值为1457.3 ms时,敏感度和特异度分别为82.8%和83.9%。结论:T_(1)-mapping技术对于评估CKD肾功能损伤具有一定的价值。
Objective:To investigate the application value of T_(1)-mapping in evaluating the renal function injury of chronic kidney disease(CKD).Methods:Twenty healthy volunteers and sixty CKD patients were recruited.The estimated glomerular filtration rate(eGFR)was calculated on the basis of serum creatinine in CKD patients,CKD patients were divided into two groups according to their eGFR:mild renal injury group[31 cases,eGFR≥60mL/(min·1.73m^(2))]and moderate to severe renal injury group[29 cases,eGFR<60mL/(min·1.73m^(2))]All subjects underwent T_(1)-mapping scan,and the renal cortical and medullary T_(1)-values were measured.The differences of T_(1)-values between the renal cortex and medulla in each group were analyzed by paired-samples t-test,respectively.The diffe-rences of the renal cortical and medullary T_(1)-values among the three groups were compared using the one-way analysis of variance(ANOVA).Correlations between renal cortical and medullary T_(1)-values and eGFR in CKD patients were assessed by Spearman correlation analysis.The diagnostic efficacy of renal cortical and medullary T_(1)-values in differentiating the degree of renal function injury was assessed by ROC curves.Results:The T_(1)-values of renal medullary were significantly higher than those of renal cortical in the three groups(all P<0.05).The T_(1)-values of renal cortex and medulla were significantly different among three groups(both P<0.01).In CKD patients,a significantly high negative correlation was found between renal cortical T_(1)-value and eGFR(r=-0.773,P<0.01),and there was a significantly moderate negative correlation between reanl medullary T_(1)-value and eGFR(r=-0.689,P<0.01).The results of the ROC curves analysis for distinguishing the healthy control group from mild renal injury group revealed that the area under ROC curve of renal medullary T_(1)-value was larger than that of renal cortex(0.866 vs.0.821),and when the cut-off of renal medullary T_(1)-value was 1505.2ms,the sensitivity and specificity for diagnosing mild renal in
作者
索朗尼玛
冒炜
曾蒙苏
周建军
丁玉芹
曹波红
丁小强
傅彩霞
SUO LANG Nima;MAO Wei;ZENG Mengsu(Department of Radiology,the People's Hospital of Tibet Autonomous Region,Tibet 850000,China)
出处
《放射学实践》
CSCD
北大核心
2023年第8期1039-1043,共5页
Radiologic Practice
基金
上海市“科技创新行动计划”启明星项目扬帆专项(22YF1443700)
国家自然科学基金面上项目(82171897)
上海市临床重点专科项目(shslczdzk03202)
上海申康医院发展中心“促进市级医院临床技能与临床创新能力三年行动计划”(SHDC2020CR1029B)。
