联合扩散张量成像和全肾体积评估慢性肾脏病患者的肾功能。
Assessment of kidney function in chronic kidney disease by combining diffusion tensor imaging and total kidney volume.
机构信息
Department of Radiology, The Affiliated Jiangning Hospital with Nanjing Medical University, No. 169, Hushan Road, Nanjing, 211100, Jiangsu Province, China.
Department of Nephrology, The Affiliated Jiangning Hospital with Nanjing Medicine University, No. 169, Hushan Road, Nanjing, 211100, Jiangsu Province, China.
出版信息
Int Urol Nephrol. 2022 Feb;54(2):385-393. doi: 10.1007/s11255-021-02886-8. Epub 2021 May 22.
OBJECTIVE
This study aimed to investigate the value and feasibility of combining fractional anisotropy (FA) values from diffusion tensor imaging (DTI) and total kidney volume (TKV) for the assessment of kidney function in chronic kidney disease (CKD).
MATERIALS AND METHODS
Fifty-one patients were included in this study. All MRI examinations were performed with a 3.0 T scanner. DTI was used to measure FA values, and TKV was obtained from DTI and T2-weighted imaging (T2WI). Patients were divided into three groups (mild, moderate, severe) according to eGFR, which was calculated with serum creatinine. Differences in the FA values of the cortex and medulla were analysed among the three groups, and the relationships of FA values, TKV, and the product of the FA values and TKV with eGFR were analysed. Receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic efficiency of the FA values, TKV, and the product of the FA values and TKV for kidney function in different CKD stages.
RESULTS
Medullary FA values (m-FA), TKV, and the product of the m-FA values and TKV (m-FA-TKV) were significantly correlated with eGFR (r = 0.653, 0.685, and 0.797, respectively; all P < 0.001). ROC curve analysis showed that m-FA-TKV exhibited better diagnostic performance than m-FA values (P = 0.022).
CONCLUSION
m-FA-TKV obtained by DTI significantly improves the accuracy of kidney function assessment in CKD patients.
目的
本研究旨在探讨联合扩散张量成像（DTI）各向异性分数（FA）值和总肾体积（TKV）评估慢性肾脏病（CKD）患者肾功能的价值和可行性。
材料与方法
本研究纳入 51 例患者，所有 MRI 检查均在 3.0T 扫描仪上进行。DTI 用于测量 FA 值，TKV 则由 DTI 和 T2 加权成像（T2WI）获得。根据血清肌酐计算的肾小球滤过率（eGFR），将患者分为三组（轻度、中度、重度）。分析三组之间皮质和髓质 FA 值的差异，并分析 FA 值、TKV、FA 值与 TKV 的乘积与 eGFR 的关系。采用受试者工作特征（ROC）曲线分析比较 FA 值、TKV、FA 值与 TKV 的乘积对不同 CKD 分期肾功能的诊断效能。
结果
髓质 FA 值（m-FA）、TKV 和 m-FA 与 TKV 的乘积（m-FA-TKV）与 eGFR 均显著相关（r=0.653、0.685 和 0.797，均 P<0.001）。ROC 曲线分析显示，m-FA-TKV 较 m-FA 值具有更好的诊断性能（P=0.022）。
结论
DTI 获得的 m-FA-TKV 显著提高了 CKD 患者肾功能评估的准确性。
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