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采用天然T1映射评估慢性肾小球肾炎患者的肾纤维化

Native T1 Mapping in Assessing Kidney Fibrosis for Patients With Chronic Glomerulonephritis.

作者信息

Wu Jianhua, Shi Zhaoyu, Zhang Yuan, Yan Jiaxin, Shang Fangfang, Wang Yao, Lu Huijian, Gu Hongmei, Dou Weiqiang, Wang Xinquan, Yuan Li

机构信息

Department of Nephrology, Affiliated Hospital of Nantong University, Jiangsu, China.

Department of Ultrasound Medicine, The Second Affiliated Hospital of Nantong University, Jiangsu, China.

出版信息

Front Med (Lausanne). 2021 Oct 18;8:772326. doi: 10.3389/fmed.2021.772326. eCollection 2021.

Abstract

To assess the utility of non-contrast enhanced native T1 mapping of the renal cortex in assessing renal fibrosis for patients with chronic glomerulonephritis (CGN). A total of 119 patients with CGN and 19 healthy volunteers (HVs) were recruited for this study. Among these patients, 43 had undergone kidney biopsy measurements. Clinical information and biopsy pathological scores were collected. According to the results of the renal biopsy, the patients were classified into the high (25-50%), low (<25%) and no renal interstitial fibrosis (IF) (0%) groups. The correlations between the T1 value in the renal cortex and each of the clinical parameters were separately analyzed. The relationships between each fibrosis group and the T1 value were also evaluated and compared between groups. Binary logistic regression analysis was further used to determine the relationship between the T1 value and renal fibrosis. Receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic value of the T1 value for renal fibrosis. Compared with those of the HVs, the T1 values were significantly higher in patients at all stages of chronic kidney disease (CKD) (all < 0.05). Significant T1 differences were also revealed between patients with different stages of CKD ( < 0.05). Additionally, the T1 value correlated well with CKD stage ( < 0.05), except between CKD 2 and 3. In addition, the T1 value was positively correlated with cystatin C, neutrophil gelatinase-associated lipocalin, and serum creatinine and negatively correlated with hemoglobin, kidney length, estimated glomerular filtration rate and hematocrit (all < 0.05). Compared with those of the no IF group, the T1 values were increased in the low- and high-IF groups (both < 0.05). Logistic regression analysis showed that an elevated T1 value was an independent risk factor for renal fibrosis. ROC analysis suggested that the optimal critical value of T1 for predicting renal fibrosis was 1,695 ms, with a specificity of 0.778 and a sensitivity of 0.625. Native T1 mapping demonstrated good diagnostic performance in evaluating renal function and was an effective noninvasive method for detecting renal fibrosis in CGN patients.

摘要

评估肾皮质非增强原生T1映射在评估慢性肾小球肾炎(CGN)患者肾纤维化中的效用。本研究共招募了119例CGN患者和19名健康志愿者(HV)。其中43例患者进行了肾活检测量。收集临床信息和活检病理评分。根据肾活检结果,将患者分为高(25%-50%)、低(<25%)和无肾间质纤维化(IF)(0%)组。分别分析肾皮质T1值与各临床参数之间的相关性。还评估了各纤维化组与T1值之间的关系,并在组间进行比较。进一步采用二元逻辑回归分析确定T1值与肾纤维化之间的关系。绘制受试者工作特征(ROC)曲线,分析T1值对肾纤维化的诊断价值。与HV相比,慢性肾脏病(CKD)各阶段患者的T1值均显著升高(均<0.05)。不同CKD阶段患者之间也显示出显著的T1差异(<0.05)。此外,T1值与CKD分期相关性良好(<0.05),CKD 2期和3期除外。此外,T1值与胱抑素C、中性粒细胞明胶酶相关脂质运载蛋白和血清肌酐呈正相关,与血红蛋白、肾长度、估计肾小球滤过率和血细胞比容呈负相关(均<0.05)。与无IF组相比,低IF组和高IF组的T1值均升高(均<0.05)。逻辑回归分析表明,T1值升高是肾纤维化的独立危险因素。ROC分析表明,预测肾纤维化的T1最佳临界值为1695 ms,特异性为0.778,敏感性为0.625。原生T1映射在评估肾功能方面表现出良好的诊断性能,是检测CGN患者肾纤维化的一种有效的非侵入性方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c36/8558353/7a9e406726f2/fmed-08-772326-g0001.jpg

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