在体素内不相干运动扩散加权成像（IVIM-DWI）中，双指数拟合比单指数拟合表现更好吗？IgA肾病肾病理损伤的评估

Does Bi-Exponential Fitting Perform Better than Mono-Exponential Fitting in IVIM-DWI? An Assessment of Renal Pathological Injury of IgA Nephropathy.

作者信息

Mao Wei, Ding Xiaoqiang, Ding Yuqin, Fu Caixia, Zeng Mengsu, Zhou Jianjun

机构信息

Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, 180 Fenglin Road, Shanghai 200032, People’s Republic of China

Department of Nephrology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, People’s Republic of China

出版信息

Curr Med Imaging. 2023 Jun 27. doi: 10.2174/1573405620666230627103919.

DOI:10.2174/1573405620666230627103919

PMID:37366355

Abstract

BACKGROUND

Chronic kidney disease has become one of the world's major public health problems, immunoglobulin A (IgA) nephropathy is a common pathological type of CKD. Delaying the progression of IgA nephropathy has currently become the main clinical treatment strategy, precise evaluation of renal pathological injury during follow-up of patients with IgA nephropathy is important. Therefore, it is imperative to develop an accurate and non-invasive imaging technique for effective follow-up of renal pathological injury in patients with IgA nephropathy.

OBJECTIVE

To investigate the clinical value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in assessing renal pathological injury in patients with immunoglobulin A (IgA) nephropathy compared with a mono-exponential model.

METHODS

Altogether, 80 patients with IgA nephropathy were divided into the mild (41 cases) andmoderate-severe (m-s) renal injury groups (39 cases) according to pathology scores, and 20 healthy volunteers were recruited as controls. All participants underwent IVIM-DWI of the kidneys, and renal parenchymal apparent diffusion coefficient (ADC), pure molecular diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) values were measured. One-way analysis of variance, receiver operating characteristic (ROC) curve analysis, and Pearson correlation analysis were performed for all the DWI-derived parameters.

RESULTS

The DWI-derived parameters of the m-s renal injury group were significantly lower than those of the mild renal injury and control groups (P < 0.01). The ROC analysis revealed that f had the largest area under the ROC curve for differentiation between the m-s and mild renal injury groups and between the m-s renal injury and control groups. The f had the largest correlation coefficient with renal pathology scores (r=-0.81), followed by the D* (-0.69), ADC (-0.54), and D values (-0.53), respectively (all P<0.01).

CONCLUSION

IVIM-DWI demonstrated better diagnostic performance than the mono-exponential model in assessing renal pathological injury in patients with IgA nephropathy.

摘要

背景

慢性肾脏病已成为全球主要的公共卫生问题之一，免疫球蛋白A（IgA）肾病是慢性肾脏病常见的病理类型。延缓IgA肾病进展已成为当前主要的临床治疗策略，对IgA肾病患者随访过程中肾脏病理损伤进行精准评估具有重要意义。因此，开发一种准确、无创的成像技术用于有效随访IgA肾病患者的肾脏病理损伤势在必行。

目的

与单指数模型相比，探讨体素内不相干运动扩散加权成像（IVIM-DWI）在评估免疫球蛋白A（IgA）肾病患者肾脏病理损伤中的临床价值。

方法

将80例IgA肾病患者根据病理评分分为轻度肾损伤组（41例）和中重度肾损伤组（39例），招募20名健康志愿者作为对照组。所有参与者均接受肾脏IVIM-DWI检查，测量肾实质表观扩散系数（ADC）、纯分子扩散系数（D）、伪扩散系数（D*）和灌注分数（f）值。对所有DWI衍生参数进行单因素方差分析、受试者工作特征（ROC）曲线分析和Pearson相关性分析。

结果

中重度肾损伤组的DWI衍生参数显著低于轻度肾损伤组和对照组（P<0.01）。ROC分析显示，f在区分中重度与轻度肾损伤组以及中重度肾损伤组与对照组方面的ROC曲线下面积最大。f与肾脏病理评分的相关系数最大（r=-0.81），其次分别为D*（-0.69）、ADC（-0.54）和D值（-0.53）（均P<0.01）。