体素内不相干运动参数值评价儿童紫癜性肾炎肾脏与正常肾脏的差异

发布时间：2018-01-17 20:18

本文关键词：体素内不相干运动参数值评价儿童紫癜性肾炎肾脏与正常肾脏的差异　出处：《临床放射学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的采用体素内不相干运动(IVIM)相关参数值分析紫癜性肾炎(HSPN)和正常儿童肾脏实质之间的差异,探讨IVIM-DWI技术在儿童HSPN诊断和鉴别诊断中的意义。方法回顾性分析本院17例经肾穿刺活检病理证实为HSPN的患者资料,正常对照组亦取17名正常儿童,两组均顺利完成中腹部常规MR平扫和IVIM-DWI序列(b值取0、50、100、150、200、400、600 s/mm~2)扫描。将扫描原始图像导入IVIM后处理软件,在所得参数标准血流量(BF)、体素内真性水分子扩散(D)、体素内微循环灌注(D~*)、灌注分数(f)图像上对两侧肾脏实质区域上极、中部、下极各放置三次感兴趣区(ROI),取其平均值。采用独立样本t检验比较HSPN肾脏与正常肾脏参数值差异。结果 HSPN与正常肾脏IVIM参数BF值在左、右侧下极差异存在统计学意义(P=0.012,0.005)、D值在左、右侧肾脏各部位差异均存在统计学意义(P=0.007,0.002,0.002;0.022,0.045,0.029),D~*值则在左、右侧各部位比较均不具有统计学意义,f值在右侧下极中差异存在统计学意义(P=0.000)。结论 IVIM参数D值可以作为鉴别HSPN肾脏与正常肾脏的良好参数,BF、f值亦能提供一定参考。IVIM-DWI可以测量正常肾组织与病理情况的血液动力学变化,在反映肾功能状态变化和疾病的鉴别诊断方面具有较高的参考价值。
[Abstract]:Objective to analyze the difference of renal parenchyma between Henoch-Schonlein purpura nephritis (HSPN) and normal children by IVIM-related parameters. To explore the significance of IVIM-DWI technique in the diagnosis and differential diagnosis of HSPN in children. Methods the data of 17 cases of HSPN confirmed by renal biopsy pathology in our hospital were retrospectively analyzed. 17 normal children were taken from the normal control group. The normal Mr scan and IVIM-DWI sequence were performed successfully in both groups. The original image was imported into the IVIM post-processing software, and the standard blood flow rate (BFF) was obtained, and the true water molecule diffusion in the voxel was obtained. Three times of ROI were placed at the upper pole, middle pole and lower pole of the renal parenchyma on the perfusion fraction (f) image. The values of HSPN kidney and normal kidney parameters were compared by independent sample t test. Results HSPN and normal kidney IVIM parameter BF were left. The difference of the right lower pole was statistically significant (P < 0.05). The D value of the left kidney and the right kidney were significantly different (P < 0.05). 0.002; There was no significant difference between the left and the right of 0.022, 0.045, 0.029, and 0. 029, and 0. 022, 0. 045 and 0. 029, respectively. The difference of F value in the right lower pole was statistically significant (P < 0. 000). Conclusion the D value of IVIM parameter can be used as a good parameter for differentiating HSPN kidney from normal kidney. F value can also provide a certain reference. IVIM-DWI can be used to measure the hemodynamic changes of normal renal tissues and pathological conditions. It has a high reference value in reflecting the changes of renal function and differential diagnosis of diseases.
【作者单位】：江苏省无锡市儿童医院医学影像科;南京市第一医院医学影像科;江苏省无锡市儿童医院肾内科;
【基金】：无锡市科技局研究基金项目(编号:CSE31N1412) 无锡市卫生局面上项目(编号:MS201426) 无锡市医管中心面上项目(编号:YGZXM1535)
【分类号】：R445.2;R726.9
【正文快照】： 过敏性紫癜(henoch-schonlein purpura,HSP)是一种伴Ig A沉积,以坏死性小血管炎为主要病理改变的全身性疾病,多累及皮肤、关节、消化道和肾脏[1]。该病发病率每年正呈逐渐升高趋势[2]。HSP多为自限性疾病,预后良好,但容易复发,长期预后取决于肾脏有无受累及其严重程度。约20%~

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