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比较多参数磁共振成像序列与实验室参数在慢性肾脏病肾功能预后中的应用。

Comparison of multiparametric magnetic resonance imaging sequences with laboratory parameters for prognosticating renal function in chronic kidney disease.

机构信息

Department of Nephrology, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0451, Japan.

Department of Radiology, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0451, Japan.

出版信息

Sci Rep. 2021 Nov 11;11(1):22129. doi: 10.1038/s41598-021-01147-z.

Abstract

Magnetic resonance imaging (MRI) is playing an increasingly important role in evaluating chronic kidney disease (CKD). It has the potential to be used not only for evaluation of physiological and pathological states, but also for prediction of disease course. Although different MRI sequences have been employed in renal disease, there are few studies that have compared the different sequences. We compared several multiparametric MRI sequences, and compared their results with the estimated glomerular filtration rate. Principal component analysis showed a similarity between T1 values and tissue perfusion (arterial spin labelling), and between fractional anisotropy (diffusion tensor imaging) and apparent diffusion coefficient values (diffusion-weighted imaging). In multiple regression analysis, only T2* values, derived from the blood oxygenation level-dependent (BOLD) MRI sequence, were associated with estimated glomerular filtration rate slope after adjusting for degree of proteinuria, a classic prognostic factor for CKD. In receiver operating characteristic curve analysis, T2* values were a good predictor of rapid deterioration, regardless of the degree of proteinuria. This suggests further study of the use of BOLD-derived T2* values in the workup of CKD, especially to predict the disease course.

摘要

磁共振成像(MRI)在评估慢性肾脏病(CKD)方面发挥着越来越重要的作用。它不仅可用于评估生理和病理状态,还可用于预测疾病进程。虽然已经在肾脏疾病中应用了不同的 MRI 序列,但比较不同序列的研究很少。我们比较了几种多参数 MRI 序列,并将其结果与估计的肾小球滤过率进行了比较。主成分分析显示 T1 值与组织灌注(动脉自旋标记)之间、各向异性分数(弥散张量成像)与表观弥散系数值(弥散加权成像)之间存在相似性。在多元回归分析中,只有来自血氧水平依赖(BOLD)MRI 序列的 T2* 值与估计的肾小球滤过率斜率相关,在调整蛋白尿程度(CKD 的一个经典预后因素)后。在受试者工作特征曲线分析中,T2* 值是快速恶化的良好预测指标,无论蛋白尿程度如何。这表明进一步研究 BOLD 衍生的 T2* 值在 CKD 检查中的应用,特别是用于预测疾病进程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e4/8586015/17fae1c2e211/41598_2021_1147_Fig1_HTML.jpg

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