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DTI 与 BOLD-MRI 联合应用于高尿酸血症肾损伤评估。

Combined application of DTI and BOLD-MRI in the assessment of renal injury with hyperuricemia.

机构信息

Medical Imaging Center, First Affiliated Hospital of Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China.

MR Research, GE Healthcare, Beijing, China.

出版信息

Abdom Radiol (NY). 2021 Apr;46(4):1694-1702. doi: 10.1007/s00261-020-02804-z. Epub 2020 Oct 19.

Abstract

OBJECTIVE

To explore the value of combined diffusion tensor imaging (DTI) and blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) in detecting early renal alterations in patients with hyperuricemia.

MATERIALS AND METHODS

Seventy-one individuals were enrolled in this study and divided into three groups according to their serum uric acid (SUA) level and clinical symptoms: healthy controls (HC, n = 23), asymptomatic hyperuricemia (AH, n = 22) and gouty arthritis (GA, n = 26). All patients underwent both DTI and BOLD-MRI examination. Renal cortical and medullary ADC, FA and R2* values were calculated, respectively, and compared among the three groups. Correlations between ADC, FA and R2* with estimated glomerular filtration rate (eGFR) and SUA in hyperuricemia were evaluated, respectively.

RESULT

In the renal cortex, the ADC, FA and R2* values of the AH and GA groups were significantly lower than those of the HC groups (p < 0.05). In the renal medulla, the ADC and FA values in AH and GA patients were significantly lower than those in healthy controls (p < 0.05). The R2* value of the GA group significantly decreased, compared to that of the AH and HC groups (p < 0.05). SUA was negatively correlated with cortical ADC, FA and R2* values (p < 0.05) as well as with medullary ADC and FA values. No significant correlation was discovered between the eGFR and ADC, FA and R2* values.

CONCLUSION

The combined evaluation of DTI and BOLD might provide a sensitive and non-invasive approach for detection of renal microstructural alterations and oxygen metabolism abnormality in hyperuricemia.

摘要

目的

探讨联合扩散张量成像(DTI)和血氧水平依赖磁共振成像(BOLD-MRI)检测高尿酸血症患者早期肾改变的价值。

材料与方法

本研究纳入 71 例患者,根据血清尿酸(SUA)水平和临床症状分为三组:健康对照组(HC,n=23)、无症状高尿酸血症(AH,n=22)和痛风性关节炎(GA,n=26)。所有患者均行 DTI 和 BOLD-MRI 检查。分别计算肾皮质和髓质 ADC、FA 和 R2值,并比较三组间的差异。分别评估 ADC、FA 和 R2与高尿酸血症患者肾小球滤过率(eGFR)和 SUA 的相关性。

结果

在肾皮质中,AH 和 GA 组的 ADC、FA 和 R2值明显低于 HC 组(p<0.05)。在肾髓质中,AH 和 GA 患者的 ADC 和 FA 值明显低于健康对照组(p<0.05)。GA 组的 R2值明显低于 AH 和 HC 组(p<0.05)。SUA 与皮质 ADC、FA 和 R2值呈负相关(p<0.05),与髓质 ADC 和 FA 值也呈负相关。eGFR 与 ADC、FA 和 R2值之间无明显相关性。

结论

DTI 和 BOLD 的联合评估可能为检测高尿酸血症患者肾微观结构改变和氧代谢异常提供一种敏感、无创的方法。

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