BOLDMRI评价原发性肾病综合征的肾内氧代谢状态

发布时间：2018-03-14 23:31

  本文选题：肾脏　切入点：血氧水平依赖　出处：《中国医学影像技术》2017年09期 　论文类型：期刊论文

【摘要】：目的采用BOLD MRI评估原发性肾病综合征(PNS)患者肾内氧代谢状态。方法收集20例初次发病且未接受治疗的PNS患者和18名健康志愿者进行BOLD MR检查,分别测量肾脏皮质和髓质的R2*值,记录检查当日PNS患者的评估肾小球滤过率(eGFR)等实验室指标。PNS患者在检查后1周内进行穿刺活检,肾小管间质病理损害评分采用Katafuchi积分标准。比较PNS患者和正常人间R2*值的差异,分析PNS患者R2*值与肾小管间质病理损害积分、eGFR等临床指标的相关性,并对PNS患者的预后情况进行随访。结果 PNS患者髓质R2*值明显低于正常人(t=-9.270,P0.001);PNS患者髓质R2*值与eGFR呈负相关(r=-0.462,P=0.040),与肾小管间质病理损害积分呈正相关(r=0.809,P0.001)。随访结果显示髓质R2*值相对增高的PNS患者预后常较差。结论 BOLD MRI能反映PNS患者肾内氧合水平及肾功能、病理损害程度,为评估PNS患者预后提供更多辅助信息。
[Abstract]:Objective to evaluate the state of renal oxygen metabolism in patients with primary nephrotic syndrome (PNS) by BOLD MRI. Methods the R2 * values of renal cortex and medulla were measured by BOLD Mr in 20 PNS patients and 18 healthy volunteers. The laboratory indexes such as glomerular filtration rate (GFR) and so on were recorded on the same day of PNS. The biopsy was performed within 1 week after the examination. The score of renal tubulointerstitial lesion was assessed by Katafuchi score. The difference of R2 * between PNS patients and normal subjects was compared. To analyze the correlation between R2 * value and renal tubulointerstitial lesion score (R2 *) in patients with PNS. The prognosis of PNS patients was followed up. Results the medullary R2 * value in PNS patients was significantly lower than that in normal controls. There was a negative correlation between R2 * value and eGFR, and a positive correlation between R2 * value and renal tubulointerstitial lesion score (r0.809 / P0.001). Conclusion BOLD MRI can reflect renal oxygenation level and renal function in PNS patients. The degree of pathological lesion provides more auxiliary information for evaluating the prognosis of PNS patients.
【作者单位】： 浙江大学医学院附属第一医院放射科;浙江大学医学院附属第一医院病理科;
【基金】：浙江省自然科学基金资助项目(LZ16H180001) 浙江省科技厅公益技术研究社会发展项目(2015C33138)
【分类号】：R445.2;R692
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本文编号：1613463