Department of Radiology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Pediatr Radiol. 2019 Jul;49(8):1032-1041. doi: 10.1007/s00247-019-04395-4. Epub 2019 Apr 19.
The aim is to evaluate the age-related changes and relationship of renal apparent diffusion coefficient (ADC) against the morphological and functional changes detected by functional magnetic resonance urography (fMRU) in children with pelvicalyceal dilation, with suspected or known ureteropelvic junction obstruction.
We retrospectively analyzed fMRUs with diffusion-weighted imaging (DWI) of the kidney in 35 subjects (25 males; median age: 7.1 years, range: 0.3-22.7 years) with 70 kidneys (40 with pelvicalyceal dilation and 30 with no pelvicalyceal dilation). Inclusion criteria were pelvicalyceal dilation, the absence of duplex kidneys and no ureteric dilation. DWI was performed with 3 diffusion gradient directions (b values = 0, 200, 500, 800 and 1,000 s/mm2). Metrics for fMRU included calyceal and renal transit times (CTT, RTT), time-to-peak (TTP), differential renal function based on volume (vDRF), Patlak number (pDRF) and combined volume and Patlak number (vpDRF). The grades of pelvicalyceal dilation, cortical thinning and corticomedullary differentiation were evaluated. The relationship between ADC values and the fMRU parameters was analyzed.
ADC increases with age in kidneys without pelvicalyceal dilation (R=0.37, P<0.001). Renal ADC does not correlate with any of the morphological or fMRU parameters (P>0.07). The median ADC of kidneys without pelvicalyceal dilation was 3.73×10 mm/s (range: 2.78-5.37×0 mm/s) and the median ADC of kidneys with pelvicalyceal dilation was 3.82×10 mm/s (range: 2.70-5.70×10 mm/s). There was no correlation between ADC and the absolute differences of vDRF or pDRF (P>0.33).
Renal ADC does not correlate with morphological and functional results of fMRU changes in children with pelvicalyceal dilation due to suspected or known ureteropelvic junction obstruction.
评估疑似或已知肾盂输尿管连接部梗阻患儿肾盂扩张肾的表观扩散系数（ADC）与功能磁共振尿路造影（fMRU）检测到的形态和功能变化的相关性，这些患儿的肾 ADC 随年龄的变化。
我们回顾性分析了 35 例（男 25 例；中位年龄：7.1 岁，范围：0.3-22.7 岁）70 个肾脏的 fMRU 扩散加权成像（DWI）数据，其中 40 个肾脏有肾盂扩张，30 个肾脏无肾盂扩张。纳入标准为肾盂扩张、无重复肾和无输尿管扩张。DWI 采用 3 个扩散梯度方向（b 值=0、200、500、800 和 1000 s/mm2）。fMRU 指标包括肾盏和肾实质通过时间（CTT、RTT）、达峰时间（TTP）、基于体积的分肾功能（vDRF）、Patlak 数（pDRF）和体积与 Patlak 数的综合值（vpDRF）。评估肾盂扩张程度、皮质变薄和皮质髓质分化程度。分析 ADC 值与 fMRU 参数之间的关系。
无肾盂扩张的肾脏 ADC 值随年龄增长而增加（R=0.37，P<0.001）。肾脏 ADC 与任何形态或 fMRU 参数均无相关性（P>0.07）。无肾盂扩张的肾脏 ADC 中位数为 3.73×10 mm/s（范围：2.78-5.37×10 mm/s），肾盂扩张的肾脏 ADC 中位数为 3.82×10 mm/s（范围：2.70-5.70×10 mm/s）。ADC 与 vDRF 或 pDRF 的绝对差异无相关性（P>0.33）。
疑似或已知肾盂输尿管连接部梗阻患儿肾盂扩张肾的 ADC 与 fMRU 形态和功能变化无相关性。
