体素不相干运动MR成像预测肾积水肾功能可复性的研究

发布时间：2018-01-15 07:26

本文关键词：体素不相干运动MR成像预测肾积水肾功能可复性的研究　出处：《放射学实践》2017年05期 　论文类型：期刊论文

【摘要】：目的:探讨体素不相干运动(IVIM)MR成像预测肾积水肾功能可复性的价值。方法:选取成年雄性新西兰大白兔30只,分为A、B、C、D、E五组(每组6只),前四组制作左侧输尿管不同程度梗阻的肾积水模型,E组为对照组,将A、B、C、D四组动物分别于造模成功后4、8、12、16周行MRI平扫及IVIM检查,对照组于造模成功后4、8、12、16周也行MRI平扫及IVIM检查,动态分析IVIM定量参数(ADC值、D值、D*值、f值)的变化特点及与病理、肾小球滤过率(GFR)的相关性,分析ADC值、D值、D*值、f值对解除梗阻后肾功能恢复的预测效能。结果:白兔左侧积水肾皮髓质D值、D*值、f值、ADC值于成模后4、8、12、16周随着肾功能受损程度加重,数值逐渐降低,D值、f值及ADC值组间两两比较:成模后12周、16周与对照组、4周,成模后8周与16周组间差异有统计学意义(P0.05);D*值组间两两比较:成模后8周、12周、16周与对照组、4周,成模后12周、16周与8周组间差异有统计学意义(P0.05);左侧积水肾成模后不同时间点D值、D*值、f值、ADC值与病理改变密切相关,与GFR呈中度正相关。解除梗阻后,8周前的积水肾功能不同程度恢复,肾皮髓质ADC值、D值、D*值、f值对肾功能恢复与未恢复的鉴别诊断有一定价值,最佳诊断阈值分别为(2.59±0.64)×10~(-3) mm~(-2)/s、(1.67±0.69)×10~(-3) mm~(-2)/s、(16.95±8.32)×10~(-3) mm~(-2)/s、(0.44±0.18)。结论:IVIM成像能有效、动态监测积水肾肾功能的变化,对解除梗阻后肾功能恢复的预测有一定价值。
[Abstract]:Objective: to evaluate the value of voxel incoherent motility IVIMI Mr imaging in predicting renal function renaturation in hydronephrosis. Methods: thirty adult male New Zealand white rabbits were divided into two groups. Group E (6 rats in each group), the first four groups were used as the control group to make hydronephrosis model with different degrees of obstruction of left ureter. MRI plain scan and IVIM examination were performed in 16 weeks, and MRI plain scan and IVIM were also performed in the control group after 4 weeks of successful modeling. The quantitative parameters of IVIM were analyzed dynamically. The change of D value and its correlation with pathology, glomerular filtration rate (GFR) and D value (D value) were analyzed. Results: the D value of left hydronephrosis (D value) and D value (D * value) and D value (D * value) and ADC value (D value) of left hydronephrosis in white rabbits were 80.12 after the model. At 16 weeks, with the severity of renal function damage, the value of D value and ADC value decreased gradually between the two groups: 12 weeks after the model, 16 weeks after the model and 4 weeks after the control group. There was significant difference between the groups at 8 and 16 weeks after model formation (P 0.05). Comparison of D * value between two groups: there was significant difference between the control group and the control group at 8 weeks, 12 weeks, 16 weeks and 8 weeks after the model, and there was a significant difference between the two groups (P 0.05). At different time points after left hydronephrosis model, D value, D * value and D * value were closely correlated with pathological changes, and were positively correlated with GFR. The function of hydronephrosis recovered 8 weeks after relief of obstruction. The ADC value and D * value of renal medulla and D * value have some value in the differential diagnosis of renal function recovery and non-recovery. The optimal diagnostic threshold was 2.59 卤0.64 脳 10 ~ (-3) mm ~ (-2) / m ~ (-1) / m ~ (-1) 卤0.69) 脳 10 ~ (-3) mm~(-2)/s, respectively. Conclusion\% IVIM imaging is effective and can dynamically monitor the changes of renal function in hydronephrosis. [WT5HZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5HZ]. It is valuable to predict the recovery of renal function after relieving obstruction.
【作者单位】：广州医科大学附属第一医院放射科;中山大学第一附属医院胸外科;
【基金】：广东省医学科研基金项目(A2015403) 广东省科技计划项目(2014A020212353) 广州市属高校科研项目(1201420047)
【分类号】：R445.2;R692
【正文快照】： 准确评估积水肾的功能和预测梗阻解除后肾功能是否恢复,是决定保留或切除积水肾的前提,目前临床上评价肾功能的指标虽然很多,但都存在一定缺陷。磁共振扩散功能成像的多b值成像即体素内不相干运动(IntravoxelIncoherent Motion,IVIM)成像能从分子水平提供组织微观结构信息,在

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