天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (7): 873-876.doi: 10.11958/20150263

• 临床研究 • 上一篇    下一篇

磁共振弥散加权成像评价IgA肾病病理及其肾功能的研究

苏妍 ， 杨丽萍 ， 黄翀 ， 龚良庚 ， 尹建华 ， 连珞 ， 秦晓华 ， 占锦峰 ， 涂卫平 ， 房向东   

  1. 1 南昌， 南昌大学第二附属医院肾内科（邮编 330006）；2江西省肿瘤医院
  • 收稿日期:2015-10-27 修回日期:2015-12-20 出版日期:2016-07-15 发布日期:2016-07-15
  • 通讯作者: 房向东 E-mail:xiangdongfang818@sina.com
  • 作者简介:苏妍（1989）， 女， 硕士研究生， 主要从事肾脏病方面研究
  • 基金资助:
    江西省卫生计生委科技计划资助项目（20151061）

Assessment of the diffusion-weighted imaging for the pathology and renal function in IgA nephropathy

SU Yan， YANG Liping， HUANG Chong， GONG Lianggeng， YIN Jianhua， LIAN Luo， QIN Xiaohua， ZHAN Jinfeng， TU Weiping， FANG Xiangdong   

  1. 1 The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China；2 Jiangxi Cancer Hospital
  • Received:2015-10-27 Revised:2015-12-20 Published:2016-07-15 Online:2016-07-15
  • Contact: FANG Xiangdong E-mail:xiangdongfang818@sina.com

PDF (PC)

3880

摘要： 目的 探究IgA肾病患者磁共振弥散加权成像（DWI）测量值与其病理及肾功能的相关性。方法 收集35例IgA肾病患者作为研究组，20例健康志愿者作为对照组，所有受试者均采用3.0T MR扫描仪进行双侧肾脏DWI成像，测量肾脏皮髓质ADC值。研究组对象采用99Tcm-DTPA闪烁扫描测定分肾的GFR，并根据Lee氏评级系统及Katafuchi评分标准，对IgA肾病患者进行病理分级与评分。比较对照组与IgA肾病各亚组之间肾脏皮髓质ADC值的差异；分析IgA肾病组分肾皮髓质ADC值与其GFR值之间的关系； IgA肾病组右肾皮髓质ADC值与其病理积分之间的关系。结果 对照组及IgA肾病各亚组的肾脏皮质ADC值均大于髓质（P＜0.05），对照组与IgA肾病各亚组之间皮、髓质ADC值均存在显著差异（P＜0.05），但IgA肾病I级组皮质ADC值与对照组之间差异无统计学意义（P＞0.05）。IgA肾病组分肾皮、髓质ADC值与其GFR值均呈正相关性（P＜0.05）；IgA肾病组的右肾皮、髓质ADC值与其病理积分均呈负相关性（P＜0.05）。结论 磁共振弥散加权成像可以反映皮髓质各自的生理效能，在IgA肾病中的应用具有可行性，尤其对评价肾脏滤过功能及病理变化有一定的临床价值，但对早期病变缺乏敏感性。

关键词: 肾小球肾炎, IGA, 磁共振成像, 弥散, 肾小球滤过率, 肾皮质, 肾髓质, 病理学

Abstract: 【Objective】To study the correlation between the diffusion-weighted imaging measurements and GFR, Katafuchi scores in IgA nephropathy. 【Methods】 Thirty-five patients with IgA nephropathy and twenty healthy volunteers were enrolled in this study. All of the subjects underwent studies on 3.0T MR scanner to obtain the diffusion-weighted imaging measurements. The glomerular filtration rate were calculated with 99Tcm-DTPA scintigraphy. We based the grades and the pathological damage scores of IgA nephropathy on the Lee classification and the Katafuchi system. To compare the ADC values between the control group and different grade of IgA nephropathy group. To analyse the correlation between the ADC values and GFR. To analyse the correlation between the ADC values and Katafuchi scores.【Results】The renal cortical ADC values were higher than medulla in both the control group and the IgA nephropathy group(p<0.05). There were statistically significant differences in renal cortical and medulla ADC values among the control group and the IgA nephropathy subgroup(p<0.05).But there was no significant difference in renal cortical ADC values between IgAN I group and the control group(p>0.05). There was a positive correlation between the renal cortical and medulla ADC values and the GFR values(p<0.05).Negative correlation was found between the renal cortical and medulla ADC values and the Katafuchi scores(p<0.05).【Conclusion】The diffusion-weighted imaging could reflect the physiological functions of the kidney. It was feasible for application on IgA nephropathy, which could be used for assessing the renal filtration function and the pathological damage. However, DWI lacked the sensitivity to early renal disease.

Key words: IgA nephropathy, diffusion-weighted imaging, glomerular filtration rate, pathology