Department of Radiology, Ruijin Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China.
Eur Radiol. 2010 Apr;20(4):978-83. doi: 10.1007/s00330-009-1619-8. Epub 2009 Sep 30.
To prospectively evaluate the feasibility of diffusion-weighted (DW) magnetic resonance (MR) imaging in the assessment of renal function in patients with chronic kidney disease (CKD).
Seventy-two healthy volunteers and 43 patients underwent coronal echo-planar DW MR imaging of the kidneys with a single breath-hold time of 16 s. The patients were grouped according to five stages as indicated by the K/DOQI CKD (kidney disease outcome quality initiative). The apparent diffusion coefficient (ADC) value of the kidneys was calculated with high b values (b = 500 s/mm(2)). The ADC values were compared between patients and healthy volunteers, and among different stages. For statistical analysis, Student's t tests, ANOVA, Pearson's correlation tests, and Spearman's correlation tests were used.
No difference between the cortex and medulla could be observed on DW images of all volunteers. Patients with CKD had significantly lower renal ADC (t = -4.383, P = 0.000) than volunteers. The ADC values of kidneys were significantly lower than normal at most stages of CKD, except CKD1. There was a negative correlation between the ADCs and serum creatinine (sCr) level (P = 0.000) amongst the patients.
Diffusion-weighted MR imaging is feasible in the assessment of renal function, especially in the detection of early stage renal failure of CKD.
前瞻性评估弥散加权（DW）磁共振成像（MR）在慢性肾脏病（CKD）患者肾功能评估中的可行性。
72 名健康志愿者和 43 名患者接受单次屏气 16 s 的冠状面 echo-planar DW MR 肾脏成像。根据 K/DOQI CKD（肾脏疾病结局质量倡议）将患者分为五期。用高 b 值（b = 500 s/mm2）计算肾脏的表观弥散系数（ADC）值。比较患者与健康志愿者以及不同分期之间的 ADC 值。统计学分析采用 Student's t 检验、方差分析、Pearson 相关检验和 Spearman 相关检验。
所有志愿者的 DW 图像上均无法观察到皮质和髓质之间的差异。CKD 患者的肾脏 ADC 值明显低于志愿者（t = -4.383，P = 0.000）。除 CKD1 期外，CKD 患者的肾脏 ADC 值在 CKD 的大多数阶段均显著低于正常，且与血清肌酐（sCr）水平呈负相关（P = 0.000）。
弥散加权 MR 成像可用于评估肾功能，尤其可用于检测 CKD 早期肾衰竭。
