磁共振弥散加权成像对糖尿病肾病临床分期的诊断价值
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摘要
目的探讨磁共振弥散加权成像(DWI)对糖尿病肾病临床分期的诊断价值。方法收集2017年10月至2018年8月在牡丹江医学院附属红旗医院经过临床及化验室检查确诊为糖尿病肾病患者并行MRI检查的患者纳入研究,90例糖尿病肾病患者均准确进行分期,纳入健康对照组10例,均行弥散加权成像(DWI)扫描(b值为0,800),并对ADC值进行测定。结果 5期糖尿病肾病患者ADC值低于4、3、2、1期及对照组患者,差异均有统计学意义,4期患者ADC值低于3期差异有统计学意义(P<0.05),对照组与1期和2期患者ADC值无统计学意义(P>0.05),4期及3期ADC值低于对照组、1期及2期患者ADC值,且差异有统计学意义(P<0.05)。结论磁共振弥散加权成像能够对糖尿病肾病肾功能的中晚期变化情况进行评估,为临床分期提供指导。
Objective To investigate the diagnostic value of diffusion-weighted imaging(DWI) for clinical staging of diabetic nephropathy. Methods Patients admitted to the Department of Endocrinology of Hongqi Hospital affiliated to Mudanjiang Medical College from October 2017 to August 1818 were enrolled in the clinical and laboratory examinations for diagnosis of diabetic nephropathy. 90 patients with diabetic nephropathy were accurately staged and included in the outpatient clinic. Ten patients in the group were subjected to diffusion-weighted imaging(DWI) scanning(b value of 0,800), and the ADC values were determined. Results The ADC values of patients with stage 5 diabetic nephropathy were lower than those of patients with stage 4, 3, 2, and 1 and the control group. The difference was statistically significant(P<0.05). The ADC values of the control group and stage 1 and stage 2 patients were not statistically significant(P>0.05). The ADC values of stage 4 and stage 3 were lower than those of the control group, stage 1 and stage 2, and the difference was statistically significant(P<0.05). Conclusion Magnetic resonance diffusion-weighted imaging can evaluate the changes of renal function in diabetic nephropathy and provide guidance for clinical staging.
Objective To investigate the diagnostic value of diffusion-weighted imaging(DWI) for clinical staging of diabetic nephropathy. Methods Patients admitted to the Department of Endocrinology of Hongqi Hospital affiliated to Mudanjiang Medical College from October 2017 to August 1818 were enrolled in the clinical and laboratory examinations for diagnosis of diabetic nephropathy. 90 patients with diabetic nephropathy were accurately staged and included in the outpatient clinic. Ten patients in the group were subjected to diffusion-weighted imaging(DWI) scanning(b value of 0,800), and the ADC values were determined. Results The ADC values of patients with stage 5 diabetic nephropathy were lower than those of patients with stage 4, 3, 2, and 1 and the control group. The difference was statistically significant(P<0.05). The ADC values of the control group and stage 1 and stage 2 patients were not statistically significant(P>0.05). The ADC values of stage 4 and stage 3 were lower than those of the control group, stage 1 and stage 2, and the difference was statistically significant(P<0.05). Conclusion Magnetic resonance diffusion-weighted imaging can evaluate the changes of renal function in diabetic nephropathy and provide guidance for clinical staging.
引文
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[8]孟倩.磁共振功能成像在慢性肾病中的临床应用研究[D].苏州大学,2014.
[9]Thoeny HC, Zumstein D, Simon-Zoula S, et al. Functional evaluation of transplanted kidneys with diffusion weighted and BOLD MR imaging:initial experience[J]. Radiology,2006,241(3):812-821.
[10]Goyal A, Sharma R, Bhalla AS, et al. Diffusion-weighted MRI in assessment of renal dysfunction[J]. Indian J Radiol Imaging,2012,22(3):155-159.
[11]秦卫和,陈学文,陈艳姣,等.糖尿病肾病的磁共振扩散成像及灌注成像研究[J].实用医技杂志,2014,21(10):1037-1039.
[12]Namimoto T, Yamashita Y, Mitsuzaki K,et al. Measurement of the apparent diffusion coefficient in diffuse renal disease by diffusion-weighted echoplanar MR imaging[J]. JMagn Reson Imaging,1999,9:832-837.
[13]Xu YF,Wang XY, Jiang XX. Relationship between renal apparent diffusion coefficient and glomerular filtration rate:preliminary study[J].Chin J Med Imaging Technol,2005,21(6):941-943.
[2]Parving HH, Mauer M, Ritz E. Diabetic nephropathy. In:Brenner BM, ed.Brenner and Rector’s The Kidney[J]. 8thed. Philadelphia,PA:Saunders Elsevier,2007,1265-1298.
[3]Ries M,Basseau F,Tyndal B,et al. Renal diffusion and BOLD MRI in experimental diabetic nephropathy[J].Journal of Magentic Resonance Imaging,2003,17(1):104-113.
[4]Yoshikawa T,Kawamitsu H,Mitchell DG,et al. ADC Measure-ment of abdominal organs and lesions using parallel imaging technique[J].AJR,2006,187(6):1521-1530.
[5]Namimoto T,Yamashita Y,Sumi S,et al.Focal liver masses:characterization with diffusion-weighted echo-planar MR imaging[J].Radiology,1997,204(3):739-744.
[6]Rong R, Zhang CY, Wang XY. Normal appearance of large field diffusion weighted imaging on 3.0T MRI[J]. Chin Med Sci J,2008,23(3):158-161.
[7]郭永榜,董国礼,刘念,等.3.0TMR多b值DWI在正常成人肾脏的应用研究[J].中国CT和MRI杂志,2014,12(09):17-19+22.
[8]孟倩.磁共振功能成像在慢性肾病中的临床应用研究[D].苏州大学,2014.
[9]Thoeny HC, Zumstein D, Simon-Zoula S, et al. Functional evaluation of transplanted kidneys with diffusion weighted and BOLD MR imaging:initial experience[J]. Radiology,2006,241(3):812-821.
[10]Goyal A, Sharma R, Bhalla AS, et al. Diffusion-weighted MRI in assessment of renal dysfunction[J]. Indian J Radiol Imaging,2012,22(3):155-159.
[11]秦卫和,陈学文,陈艳姣,等.糖尿病肾病的磁共振扩散成像及灌注成像研究[J].实用医技杂志,2014,21(10):1037-1039.
[12]Namimoto T, Yamashita Y, Mitsuzaki K,et al. Measurement of the apparent diffusion coefficient in diffuse renal disease by diffusion-weighted echoplanar MR imaging[J]. JMagn Reson Imaging,1999,9:832-837.
[13]Xu YF,Wang XY, Jiang XX. Relationship between renal apparent diffusion coefficient and glomerular filtration rate:preliminary study[J].Chin J Med Imaging Technol,2005,21(6):941-943.
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