BOLD MRI对糖尿病大鼠肾脏早期损伤的动态评估研究

发布时间：2018-03-11 22:31

本文选题：糖尿病肾病　切入点：磁共振成像　出处：《中国临床医学影像杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的 :磁共振血氧水平依赖成像(BOLD MRI)对糖尿病大鼠模型及正常对照组进行肾内氧和代谢动态评估,确定BOLD MRI成像对糖尿病肾脏早期损伤评价的意义。方法 :将造模成功的62只糖尿病大鼠作为实验组(DN组,n=62),正常10只大鼠作为对照组(NC组,n=10)。NC组作为BOLD MRI扫描基线,DN组在造模成功后3,7,14,21,28,35,42,49,56,63和70天成像。获得肾脏皮髓质R2*值(CR2*,MR2*)及髓皮质R2*值比值(MCR)。同时检测DN组大鼠微量蛋白尿(UAE)以及大鼠肾脏病理标本评估肾小球硬化指数(GSI),系膜容积(Vvmes),肾小球毛细血管面积(Svcap)的检测。结果:DN组CR2*和MR2*值逐渐上升,与正常对照组比较有显著差异。在35天达到最高值(MR2*=(43.79±1.46)s~(-1),CR2*=(33.95±0.34)s~(-1));之后有所下降至第70天为MR2*=(41.61±0.95)s~(-1),CR2*=(33.17±0.69)s~(-1),但仍高于NC组(P0.01)。MCR亦呈先升后降的动态过程,42天达到高峰1.32,70天时为1.25。DN组大鼠的生化指标以及病理学检查数据均有增高,与对照组比较呈显著差异。其中大鼠成模第7天DN组与NC组的UAE出现显著差异(P0.01)。结论:BOLD MRI可以对糖尿病引起的肾脏损伤的动态过程进行氧代谢方面的无创性评估,且比微量白蛋白能更早的反应出肾脏病理生理变化;本实验获得MCR的动态改变可能提示肾脏损伤从功能性高渗代偿进入器质性病变如系膜基质增生、肾小球硬化等病变。
[Abstract]:Objective: to evaluate the dynamic changes of renal oxygen and metabolism in diabetic rat model and normal control group. To determine the significance of BOLD MRI imaging in the evaluation of early diabetic kidney injury. Methods: 62 diabetic rats were selected as experimental group and 10 normal rats as control group as control group. NC group was used as baseline of BOLD MRI scanning. In the DN group, the renal medulla R2 * and the ratio of R2 * value of the medulla of the kidney and the ratio of the R2 * value of the medulla of the kidney and the ratio of the R2 * value to the R2 * value of the medullary cortex were obtained. The microalbuminuria UAE of the DN group and the glomerulosclerosis index (GSII) and the Mesangial membrane of the glomerulosclerosis index (GSI) were assessed in the renal pathological specimens of the DN group. Results the values of CR2 * and MR2 * increased gradually in the group of 10% DN, and the volume of Vvmesa, glomerular capillary area and Svcap.Results the values of CR2 * and MR2 * increased gradually. There was a significant difference between the control group and the control group on the 35th day. The maximum value of MR2C was 43.79 卤1.46 ~ (1) C ~ (-1) on the 35th day, 33.95 卤0.34 ~ (1) C ~ (-1), and then decreased to 70 ~ (th) day, which was MR2*=(41.61 卤0. 95 ~ 0. 95 卤0. 69 ~ (1) C ~ (-1), but it was still higher than that of the NC group in the dynamic process of rising first and then decreasing, reaching a peak of 1. 32N on 42 days and a peak of 1. 25% at day 1. 25. 2. The results of this study were as follows: (1) in the control group, there was no significant difference between the control group and the control group, but it was still higher than that in the NC group (P 0. 01) and then decreased to a peak of 1. 325%. The indexes and pathological data were increased, There was a significant difference in UAE between DN group and NC group on the 7th day of rat model. Conclusion the UAE of DN group and NC group can be evaluated by MRI in the dynamic process of renal injury induced by diabetes mellitus. The dynamic changes of MCR in this experiment may suggest that the renal injury changes from functional hypertonic compensation to organic diseases such as Mesangial matrix hyperplasia glomerulosclerosis and so on.
【作者单位】：浙江大学医学院附属第一医院;浙江大学医学院附属第四医院;
【基金】：浙江省自然基金(2015C33138) 浙江省科技厅社会公益项目(LZ16H180001)
【分类号】：R445.2;R587.2

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