Liao Zhouyan, Yuan Guanjie, He Kangwen, Li Shichao, Gao Mengmeng, Liang Ping, Xu Chuou, Zhang Yu, Li Zhen
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Department of Paediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Bioengineering (Basel). 2024 Jul 24;11(8):750. doi: 10.3390/bioengineering11080750.
To explore the Oxford classification and prognostic risk stratification of the non-invasive evaluation of immunoglobulin A nephropathy (IgAN) or immunoglobulin A vasculitis with nephritis (IgAVN) in children using multiparametric magnetic resonance imaging (MRI).
Forty-four children diagnosed with IgAN or IgAVN were included. Patients with 80-month risk scores >10% were categorized as the high-risk group, while others constituted the low-risk group. The T2* and apparent diffusion coefficient (ADC) values of the renal cortex and medulla were measured. Clinical and pathological parameters were also assessed. Univariate and multivariate logistic regression analyses were performed to identify the indicators associated with the high-risk group. Receiver operating characteristic (ROC) curves were drawn and the areas under the curve (AUCs) were calculated to evaluate the diagnostic performance variables for differentiating the high-risk group from the low-risk group.
Only the T2Cortex and mean arterial pressure (MAP) were independently reliable in both the univariate and multivariate analyses. The AUCs for differentiating the high-risk group from the low-risk group of T2Cortex, MAP, and their combination model were 0.907, 0.881, and 0.947, respectively.
Multiparametric MRI parameters, especially T2* values, could be used as new biomarkers to provide a new dimension in chronic kidney disease-related research and could play an important role in the non-invasive prognosis of children with IgAN or IgAVN.
探讨使用多参数磁共振成像（MRI）对儿童免疫球蛋白A肾病（IgAN）或免疫球蛋白A血管炎伴肾炎（IgAVN）进行非侵入性评估的牛津分类及预后风险分层。
纳入44例诊断为IgAN或IgAVN的儿童。风险评分>10%且病程80个月的患者归为高危组，其余为低危组。测量肾皮质和髓质的T2*值及表观扩散系数（ADC）值。同时评估临床和病理参数。进行单因素和多因素逻辑回归分析以确定与高危组相关的指标。绘制受试者工作特征（ROC）曲线并计算曲线下面积（AUC），以评估区分高危组和低危组的诊断性能变量。
在单因素和多因素分析中，只有T2皮质值和平均动脉压（MAP）是独立可靠的。区分高危组和低危组的T2皮质值、MAP及其联合模型的AUC分别为0.907、0.881和0.947。
多参数MRI参数，尤其是T2*值，可作为新的生物标志物，为慢性肾脏病相关研究提供新的维度，并在IgAN或IgAVN儿童的非侵入性预后评估中发挥重要作用。
