DWI在慢性肾脏病诊断中的应用.docVIP

DWI在慢性肾脏病诊断中的应用 　　[摘要] 目的 探讨DWI在慢性肾脏病诊断中的应用。 方法 选择2014年4～12月在我院治疗的双肾弥漫性病变患者45例为肾病组，选择健康志愿者30例为对照组。所有研究对象均进行磁共振加权成像，分析磁共振加权成像在慢性肾脏病诊断中的应用。 结果 对照组DWI图显示，肾脏皮质的信号较髓质强，皮质髓质分界清晰。肾病组患者，CKD 1期、2期患者肾脏大小正常，1期患者皮质髓质分界较2期患者清晰，2期患者皮质髓质信号对比度下降。3期患者肾脏体积缩小，皮质薄，皮质髓质分界更为模糊。皮质ADC值显著高于髓质（P0.01）；皮质ADC与GFR值呈显著正相关（r=0.588， r=0.767）。 结论 肾脏DWI图像上肾皮质和髓质成像特点不同。肾脏皮质和髓质ADC值可以反映慢性肾脏病的病情，与GFR呈显著正相关的关系。 　　[关键词] 磁共振加权成像；慢性肾脏病；皮质；髓质 　　[中图分类号] R692；R445.2 [文献标识码] B [文章编号] 1673-9701（2015）30-0097-04 　　Application of DWI in chronic kidney disease 　　JIA Peng HUANG Danjiang HUANG Yong CHEN Yunkui 　　Radiology Department， Taizhou First Peoples Hospital in Zhejiang Province， Taizhou 318000， China 　　[Abstract] Objective To discuss application of DWI in chronic kidney disease. Methods Selected 45 cases with CKD from Apr to Dec 2014 were CKD group， and 30 healthy volunteers were control group. All subjects were detected with DWI. Application of DWI in diagnosis of CKD was analyzed. Results DWI of control group showed that， signal of kidney cortex was stronger than the medulla， and demarcation of cortex and medulla was clear. DWI of CKD group showed that， CKD period 1， 2 patients were with normal kidney size， demarcation of period 1 was clearer than period 2， and signal contrast between cortex and medulla of period 2 decreased. CKD period 3 patients were with narrowed kidney volume， thin cortex， and demarcation of cortex and medulla was more blurred. ADC value of cortex was higher than medulla（P0.01）； ADC values of cortex and medulla showed positive correlation with GFR（r=0.588， r=0.767）. Conclusion Imaging features of cortex and medulla in DWI are differente. ADC values of cortex and medulla can reflect the condition of chronic kidney disease， and is positive correlation with GFR. 　　[Key words] DWI； Chronic kidney disease； Cortex； Medulla 　　慢性肾脏病（chronic kidney disease，CKD）最终可发展为肾衰竭。随着社会老龄化和人们生活习惯改变，高血压、糖尿病发病率增加，而慢性肾脏病的发病率也有上升的趋势，严重威胁人们的健康。慢性肾脏病早期因没有明显的临床症状，因此早期诊断率相对较低，不能进行及时治疗，最终发展为肾衰竭，危及患者生命[1，2]