狼疮性肾炎肾皮质的弥散张量成像。
Diffusion tensor imaging of renal cortex in lupus nephritis.
机构信息
Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, 13551, Egypt.
Rheumatology and Immunology Unit, Internal Medicine Department, Mansoura Faculty of Medicine, Mansoura, Egypt.
出版信息
Jpn J Radiol. 2021 Nov;39(11):1069-1076. doi: 10.1007/s11604-021-01154-0. Epub 2021 Jun 14.
PURPOSE
To evaluate the diagnostic value of diffusion tensor imaging (DTI) of renal cortex in assessment of lupus nephritis (LN) and prediction of its pathological subtypes.
METHODS
Prospective study was performed upon 39 female patients with pathologically proven LN and 16 sex- and age-matched healthy controls. Patients and controls underwent DTI of kidney. Mean diffusivity (MD) and fractional anisotropy (FA) of renal cortex were calculated by two radiologists. LN patients were pathologically classified into either non-proliferative (n = 15) or proliferative (n = 24).
RESULTS
Mean MD of renal cortex in LN was significantly lower (p = 0.001) than that of controls with cut-off (2.16 and 2.2 X10mm/s), area under curve (AUC) of (0.92, 0.94) and accuracy of (91%, 89%) for both observers. Mean FA of renal cortex in LN was significantly higher (p = 0.001) than that of controls with cut-off (0.20, 0.21), AUC of (0.86, 0.82) and accuracy of (86%, 84%) for both observers. Renal cortex MD and FA in non-proliferative LN were significantly different (p = 0.001) from that of proliferative LN for both observers. There was excellent inter-observer agreement of MD and FA (ICC = 0.96 and 0.81).
CONCLUSION
MD and FA of renal cortex may help to assess renal affection in LN patients and predict its pathological subtypes.
目的
评估肾脏皮质弥散张量成像（DTI）在狼疮肾炎（LN）评估和预测其病理亚型中的诊断价值。
方法
对 39 例经病理证实的 LN 女性患者和 16 名性别和年龄匹配的健康对照进行前瞻性研究。患者和对照均行肾脏 DTI 检查。由 2 名放射科医生计算肾脏皮质的平均弥散度（MD）和各向异性分数（FA）。LN 患者行病理分类，分为非增殖性（n=15）或增殖性（n=24）。
结果
LN 患者肾脏皮质 MD 明显低于对照组（p=0.001），其截断值为（2.16 和 2.2 X10mm/s），观察者 1 和观察者 2 的曲线下面积（AUC）分别为（0.92，0.94）和（0.86，0.82），准确率分别为（91%，89%）和（86%，84%）。LN 患者肾脏皮质 FA 明显高于对照组（p=0.001），其截断值为（0.20，0.21），观察者 1 和观察者 2 的 AUC 分别为（0.86，0.82）和（0.81，0.76），准确率分别为（86%，84%）和（84%，79%）。观察者 1 和观察者 2 均显示，非增殖性 LN 的肾脏皮质 MD 和 FA 与增殖性 LN 显著不同（p=0.001）。MD 和 FA 的观察者间一致性均极好（ICC=0.96 和 0.81）。
结论
肾脏皮质 MD 和 FA 有助于评估 LN 患者的肾脏受累情况，并预测其病理亚型。
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