狼疮性肾炎应用高级磁共振成像的临床研究。
Clinical study on the use of advanced magnetic resonance imaging in lupus nephritis.
机构信息
Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, China.
Department of Nephrology, Jiangxi Provincial People's Hospital, Nanchang, 330006, China.
出版信息
BMC Med Imaging. 2022 Nov 30;22(1):210. doi: 10.1186/s12880-022-00928-w.
OBJECTIVES
To investigate the correlation between the histopathology of the kidney and clinical indicators in patients with lupus nephritis (LN) using magnetic resonance imaging (MRI).
METHODS
A total 50 female participants were enrolled in the study. Thirty patients with LN were divided into types 2, 3, 4, and 5, according to their pathological features. The control group consisted of 20 healthy female volunteers. Serum creatinine, C3, C1q, and anti-ds-DNA were measured. Conventional MRI, DTI, DWI, and BOLD scanning was performed to obtain the FA, ADC, and R2* values for the kidney.
RESULTS
Compared with the control group, FA and the ADC were decreased in patients with LN, while the R2* value was increased (P < 0.05). The overall comparison of the SLEDAI (Activity index of systemic lupus erythematosus) score, total pathological score, AI, and serum creatinine C3 showed that these were significantly different between the two groups (P < 0.05). FA and the ADC were negatively correlated with urinary, blood ds-DNA, and serum creatinine and positively correlated with C1q (P < 0.05). The R2* value was positively correlated with urinary NGAL, blood ds-DNA, and serum creatinine (P < 0.05). FA and the ADC were negatively correlated with the SLEDAI score, total pathological score, AI, CI, nephridial tissue C3, and C1q. The R2* value was positively correlated with the SLEDAI score, total pathological score, AI, CI, nephridial tissue C3, and C1q (P < 0.05).
CONCLUSIONS
MRI examination in female patients with LN was correlated with pathologic test results, which may have clinical significance in determining the disease's severity, treatment, and outcome.
目的
利用磁共振成像（MRI）研究狼疮性肾炎（LN）患者肾脏的组织病理学与临床指标的相关性。
方法
共纳入 50 名女性参与者，其中 30 例 LN 患者根据病理特征分为 2、3、4 和 5 型，对照组由 20 名健康女性志愿者组成。检测血清肌酐、C3、C1q 和抗 ds-DNA。对肾脏进行常规 MRI、DTI、DWI 和 BOLD 扫描，获得 FA、ADC 和 R2* 值。
结果
与对照组相比，LN 患者的 FA 和 ADC 降低，而 R2* 值升高（P<0.05）。SLEDAI（系统性红斑狼疮活动指数）评分、总病理评分、AI 和血清肌酐 C3 的总体比较显示，两组间差异有统计学意义（P<0.05）。FA 和 ADC 与尿、血 ds-DNA 和血清肌酐呈负相关，与 C1q 呈正相关（P<0.05）。R2值与尿 NGAL、血 ds-DNA 和血清肌酐呈正相关（P<0.05）。FA 和 ADC 与 SLEDAI 评分、总病理评分、AI、CI、肾组织 C3 和 C1q 呈负相关。R2值与 SLEDAI 评分、总病理评分、AI、CI、肾组织 C3 和 C1q 呈正相关（P<0.05）。
结论
LN 女性患者的 MRI 检查与病理检查结果相关，这可能对确定疾病的严重程度、治疗和预后具有临床意义。
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