Mao Wei, Zhou Jianjun, Zeng Mengsu, Ding Yuqin, Qu Lijie, Chen Caizhong, Ding Xiaoqiang, Wang Yaqiong, Fu Caixia, Gu Feng
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, People's Republic of China.
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, People's Republic of China.
Magn Reson Imaging. 2018 Apr;47:118-124. doi: 10.1016/j.mri.2017.12.010. Epub 2017 Dec 5.
To investigate the potential of Intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI) for the assessment of renal fibrosis in chronic kidney disease (CKD), using histopathology as a reference standard.
Eighty-five CKD patients and twenty healthy volunteers were recruited in this study. IVIM-DWI was performed in all of the participants, and all of the CKD patients underwent renal biopsy. The mean values of the true diffusion coefficient (D), pseudo diffusion coefficient (D*) and perfusion fraction (f) in the renal cortex and medulla were compared between the CKD patients and healthy volunteers. The Spearman correlation coefficient was calculated to assess the relationship between the D, D*,f values and the estimated glomerular filtration rate (eGFR), serum creatinine level (SCr), 24h urinary protein level (24h-UPRO), histopathological fibrosis scores.
The D, D* and f values were significantly lower in medulla than in the cortex for all of the participants. All of the IVIM parameters were significantly lower in the CKD patients than in the healthy controls. In the CKD patients, a significant negative correlation was found between the renal parenchymal D, D*,f values and the 24h-UPRO, as well as between the renal parenchymal D, f values and the SCr. There was a significant positive correlation between all of the IVIM parameters and the eGFR. All of the IVIM parameters exhibited a significant negative correlation with the histopathological fibrosis score.
IVIM-DWI shows great potential in the noninvasive assessment of renal fibrosis in CKD.
以组织病理学为参考标准，探讨体素内不相干运动扩散加权成像（IVIM-DWI）评估慢性肾脏病（CKD）肾纤维化的潜力。
本研究纳入85例CKD患者和20名健康志愿者。所有参与者均行IVIM-DWI检查，所有CKD患者均接受肾活检。比较CKD患者和健康志愿者肾皮质和髓质的真实扩散系数（D）、伪扩散系数（D*）和灌注分数（f）的平均值。计算Spearman相关系数，以评估D、D*、f值与估计肾小球滤过率（eGFR）、血清肌酐水平（SCr）、24小时尿蛋白水平（24h-UPRO）、组织病理学纤维化评分之间的关系。
所有参与者髓质的D、D和f值均显著低于皮质。CKD患者的所有IVIM参数均显著低于健康对照。在CKD患者中，肾实质D、D、f值与24h-UPRO之间以及肾实质D、f值与SCr之间存在显著负相关。所有IVIM参数与eGFR之间存在显著正相关。所有IVIM参数与组织病理学纤维化评分均呈显著负相关。
IVIM-DWI在CKD肾纤维化的无创评估中显示出巨大潜力。
