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肾脏的体素内不相干运动成像:在高尿酸血症患者中的应用。

Intravoxel incoherent motion imaging of the kidney: The application in patients with hyperuricemia.

作者信息

Cheng Zhong-Yuan, Feng You-Zhen, Hu Jun-Jiao, Lin Qi-Ting, Li Wei, Qian Long, Cai Xiang-Ran

机构信息

Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.

Medical Imaging Center, Zhuhai People's Hospital, Zhuhai, China.

出版信息

J Magn Reson Imaging. 2020 Mar;51(3):833-840. doi: 10.1002/jmri.26861. Epub 2019 Jul 18.

Abstract

BACKGROUND

Hyperuricemia is an independent risk factor for onset and progression of kidney disease. However, there remains a lack of a reliable and noninvasive biomarker to identify and monitor the changes of renal function in patients with hyperuricemia.

PURPOSE

To assess the utility of intravoxel incoherent motion (IVIM) parameters in identifying the early changes of renal function in patients with hyperuricemia.

STUDY TYPE

Retrospective case-control study.

POPULATION

Eighty-four male participants, including asymptomatic hyperuricemia (AH, 27 cases), gouty arthritis (GA, 31 cases), and 26 age-matched healthy controls.

FIELD STRENGTH/SEQUENCE: 3.0T; intravoxel incoherent motion (IVIM).

ASSESSMENT

Differences in the IVIM parameters among the three groups were assessed. Pure molecular diffusion (D value); perfusion-related diffusion (D* value); pseudodiffusion fraction (f value); apparent diffusion coefficient (ADC value); estimated glomerular filtration rate (eGFR). Also, they were correlated with eGFR.

STATISTICAL TESTS

Bonferroni test, Tamhane's T method, and Pearson correlation analysis.

RESULTS

The D values in renal cortex and medulla significantly decreased from the control, AH to GA groups (P < 0.05). The GA patients had a significantly lower cortical f value than the controls and AH patients (P < 0.05). The medullary f values in the AH and GA patients were significantly lower than that in the controls (P < 0.05). Also, the cortical and medullary ADC values had similar results across the three groups (P < 0.05), except for the comparison between the AH and GA groups (P = 0.668, P = 0.111, respectively). No significant correlation was found between any IVIM parameters with eGFR.

DATA CONCLUSION

IVIM imaging may be helpful for detecting the early changes of renal function induced by hyperuricemia. The D value could be the most sensitive IVIM-derived parameter in the assessment of renal function in patients with hyperuricemia in this study.

LEVEL OF EVIDENCE

3 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2020;51:833-840.

摘要

背景

高尿酸血症是肾脏疾病发生和进展的独立危险因素。然而,目前仍缺乏一种可靠的非侵入性生物标志物来识别和监测高尿酸血症患者肾功能的变化。

目的

评估体素内不相干运动(IVIM)参数在识别高尿酸血症患者肾功能早期变化中的作用。

研究类型

回顾性病例对照研究。

研究对象

84名男性参与者,包括无症状高尿酸血症(AH,27例)、痛风性关节炎(GA,31例)和26名年龄匹配的健康对照者。

场强/序列:3.0T;体素内不相干运动(IVIM)。

评估指标

评估三组间IVIM参数的差异。纯分子扩散(D值);灌注相关扩散(D*值);伪扩散分数(f值);表观扩散系数(ADC值);估计肾小球滤过率(eGFR)。此外,将这些参数与eGFR进行相关性分析。

统计学检验

Bonferroni检验、Tamhane's T方法和Pearson相关性分析。

结果

肾皮质和髓质的D值从对照组、AH组到GA组显著降低(P < 0.05)。GA患者的皮质f值显著低于对照组和AH患者(P < 0.05)。AH和GA患者的髓质f值显著低于对照组(P < 0.05)。此外,除AH组和GA组之间的比较外(分别为P = 0.668,P = 0.111),三组间皮质和髓质的ADC值有相似结果(P < 0.05)。未发现任何IVIM参数与eGFR之间存在显著相关性。

数据结论

IVIM成像可能有助于检测高尿酸血症引起的肾功能早期变化。在本研究中,D值可能是评估高尿酸血症患者肾功能时最敏感的IVIM衍生参数。

证据水平

3 技术效能阶段:3 《磁共振成像杂志》2020年;51:833 - 840。

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