Yalçin-Şafak Kadihan, Ayyildiz Muhammet, Ünel Sacide Yekta, Umarusman-Tanju Neslihan, Akça Ahmet, Baysal Tamer
Kartal Dr Lütfü Kırdar Training and Research Hospital-Radiology Department, Turkey.
Eur J Radiol Open. 2015 Dec 9;3:8-11. doi: 10.1016/j.ejro.2015.10.002. eCollection 2016.
To evaluate the relationship of apparent diffusion coefficient (ADC) values of renal parenchyma with chronic kidney disease (CKD) stage and serum creatinine levels.
One hundred and ten patients who had undergone magnetic resonance imaging of the upper abdomen for different reasons were retrospectively studied. A region of interest (ROI) was placed on the renal parenchyma for measurement of ADC values of both kidneys, without any preference for cortex or medulla. Three circular ROIs were placed-one each in the upper pole, interpolar region and lower pole of both kidneys. The mean ADC values were recorded for each patient and the relationship between ADC values and stage of CKD and serum creatinine levels were evaluated.
Statistically significant difference was determined between the ADC values of the cases according to CKD stages (p < 0.001). Paired comparisons performed to determine the group that caused the difference revealed that median ADC values of healthy subjects who formed the control group was statistically significantly higher than that of the cases with stage 3, stage 4 and stage 5 CKD (p: 0.008; p: 0.008; and p: 0.002, respectively). Sensitivity and specificity were found to be 75.44% and 69.81%, respectively in detecting stage 3, stage 4 and stage 5 CKD among the cases with ADC values of 1151 and lower.
ADC values can play a role in the evaluation of renal dysfunction. However, population-and protocol-based cut-off ADC values are needed to identify renal dysfunction and to distinguish between different stages of CKD.
评估肾实质表观扩散系数（ADC）值与慢性肾脏病（CKD）分期及血清肌酐水平之间的关系。
回顾性研究110例因不同原因接受上腹部磁共振成像检查的患者。在肾实质放置感兴趣区（ROI）以测量双肾的ADC值，对皮质或髓质无偏好。在双肾的上极、极间区域和下极各放置三个圆形ROI。记录每位患者的平均ADC值，并评估ADC值与CKD分期及血清肌酐水平之间的关系。
根据CKD分期，病例组的ADC值存在统计学显著差异（p < 0.001）。进行配对比较以确定导致差异的组，结果显示作为对照组的健康受试者的中位ADC值在统计学上显著高于CKD 3期、4期和5期的病例组（p值分别为0.008、0.008和0.002）。在ADC值为1151及以下的病例中，检测CKD 3期、4期和5期的敏感性和特异性分别为75.44%和69.81%。
ADC值可在肾功能障碍评估中发挥作用。然而，需要基于人群和方案的ADC值临界值来识别肾功能障碍并区分CKD的不同阶段。
