Kanpittaya Jaturat, Apipattarakul Wichuda, Chotmongkol Verajit, Sawanyawisuth Kittisak
Department of Radiology, Thailand.
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Eur J Radiol Open. 2020 Dec 10;8:100304. doi: 10.1016/j.ejro.2020.100304. eCollection 2021.
Apparent diffusion coefficient (ADC) has been shown to indicate renal function in various conditions. As cholangiocarcinoma may have renal involvement due to immune complex-mediated glomerulonephritis, this study aimed to determine whether or not there is any association between ADC values and renal function in these patients.
This was a retrospective, analytical study. The inclusion criteria were age over 18 years, pathologically proven cholangiocarcinoma diagnosis and having undergone either 1.5 T or 3.0 T diffusion-weighted MRI. Chronic kidney disease (CKD) was defined as eGFR less than 60 mL/min/1.73m. Patients' ADC levels in the CKD and non-CKD groups were compared, and subgroup analysis was performed by MRI field strength and type of cholangiocarcinoma.
One hundred fifty-eight patients participated in the study. Most were male (66.46 %), and the average age (SD) was 61.59 years (7.91). Average ADC levels in the CDK and non-CDK group differed significantly, regardless of MRI field strength or type of cholangiocarcinoma (2.11 mm/s in the ADC group vs 1.91 mm/s in the non-ADC group; < 0.001). An ADC cut-point of 1.75 mm/s yielded sensitivities ranging from 66.67-90.00 in almost all study populations. The distal cholangiocarcinoma group had a perfect cut-point at 1.78 mm/s with 100 % sensitivity and area under the ROC curve.
Radiologists can use ADC to detect CKD in cholangiocarcinoma patients regardless of MRI field strength or type of cholangiocarcinoma.
表观扩散系数（ADC）已被证明可在各种情况下指示肾功能。由于胆管癌可能因免疫复合物介导的肾小球肾炎而累及肾脏，本研究旨在确定这些患者的ADC值与肾功能之间是否存在关联。
这是一项回顾性分析研究。纳入标准为年龄超过18岁、经病理证实的胆管癌诊断且接受过1.5T或3.0T扩散加权磁共振成像（MRI）。慢性肾脏病（CKD）定义为估算肾小球滤过率（eGFR）低于60 mL/min/1.73m²。比较CKD组和非CKD组患者的ADC水平，并按MRI场强和胆管癌类型进行亚组分析。
158例患者参与了本研究。大多数为男性（66.46%），平均年龄（标准差）为61.59岁（7.91岁）。无论MRI场强或胆管癌类型如何，CKD组和非CKD组的平均ADC水平均有显著差异（ADC组为2.11 mm²/s，非ADC组为1.91 mm²/s；P<0.001）。ADC切点为1.75 mm²/s时，几乎在所有研究人群中的敏感性范围为66.67%-90.00%。远端胆管癌组在1.78 mm²/s处有一个完美的切点，敏感性为100%，ROC曲线下面积也最佳。
无论MRI场强或胆管癌类型如何，放射科医生均可使用ADC来检测胆管癌患者的CKD。
