Goyal Ankur, Sharma Raju, Bhalla Ashu S, Gamanagatti Shivanand, Seth Amlesh
Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India.
Indian J Radiol Imaging. 2012 Jul;22(3):155-9. doi: 10.4103/0971-3026.107169.
Diffusion-weighted magnetic resonance imaging (DW-MRI) in renal diseases is an evolving field and its potential is yet to be fully realized.
To study the relationship between apparent diffusion coefficient (ADC) values of renal parenchyma and serum markers of renal function and stage of chronic kidney disease (CKD).
A retrospective review was performed of all adult patients who underwent DW-MRI (at b-values of 0 and 500 s/mm(2)) for renal lesions from January 2009 to September 2010 and revealed 88 patients, of which 22 patients had renal dysfunction and 66 had normal renal function. Of these 22, 15 patients were known cases of CKD and were staged depending on disease severity. ADC values were determined for renal parenchyma and compared. Receiver operating characteristic (ROC) curves were drawn to establish cut-off ADC values. Pearson's correlation coefficient (R) was calculated between ADC and renal function parameters.
ADC values in patients with renal dysfunction were significantly lower than in patients with normal renal function (2.1133 ± 0.2851 vs. 2.3198 ± 0.1246 (×10(-3) mm(2)/s)). ADC values lower than 2.0354 (×10(-3) mm(2)/s) were seen only with renal dysfunction and higher than 2.4516 (×10(-3) mm(2) /s) were seen only with normal function. There was significant inverse correlation between ADC and serum creatinine (R = -0.530), blood urea (R= -0.502), and significant linear correlation (R = 0.784) with estimated glomerular filtration rate (eGFR). ADC values showed a statistically significant decreasing trend with increasing stage of CKD.
ADC values may serve as an additional marker for the presence and degree of renal dysfunction.
肾脏疾病的扩散加权磁共振成像（DW-MRI）是一个不断发展的领域，其潜力尚未得到充分发挥。
研究肾实质表观扩散系数（ADC）值与肾功能血清标志物及慢性肾脏病（CKD）分期之间的关系。
对2009年1月至2010年9月因肾脏病变接受DW-MRI（b值为0和500 s/mm(2)）检查的所有成年患者进行回顾性研究，共纳入88例患者，其中22例肾功能不全，66例肾功能正常。在这22例肾功能不全患者中，15例为已知的CKD病例，并根据疾病严重程度进行分期。测定肾实质的ADC值并进行比较。绘制受试者工作特征（ROC）曲线以确定ADC的临界值。计算ADC与肾功能参数之间的Pearson相关系数（R）。
肾功能不全患者的ADC值显著低于肾功能正常患者（2.1133±0.2851 vs. 2.3198±0.1246（×10(-3) mm(2)/s））。仅在肾功能不全患者中观察到ADC值低于2.0354（×10(-3) mm(2)/s），仅在肾功能正常患者中观察到ADC值高于2.4516（×10(-3) mm(2)/s）。ADC与血清肌酐（R = -0.530）、血尿素（R = -0.502）呈显著负相关，与估计肾小球滤过率（eGFR）呈显著正相关（R = 0.784）。随着CKD分期增加，ADC值呈现出统计学上显著的下降趋势。
ADC值可作为肾功能不全存在及程度的附加标志物。
