本文選題：腎臟　切入點(diǎn)：血氧水平依賴　出處：《中國(guó)醫(yī)學(xué)影像技術(shù)》2017年09期 　論文類型：期刊論文

【摘要】：目的采用BOLD MRI評(píng)估原發(fā)性腎病綜合征(PNS)患者腎內(nèi)氧代謝狀態(tài)。方法收集20例初次發(fā)病且未接受治療的PNS患者和18名健康志愿者進(jìn)行BOLD MR檢查,分別測(cè)量腎臟皮質(zhì)和髓質(zhì)的R2*值,記錄檢查當(dāng)日PNS患者的評(píng)估腎小球?yàn)V過(guò)率(eGFR)等實(shí)驗(yàn)室指標(biāo)。PNS患者在檢查后1周內(nèi)進(jìn)行穿刺活檢,腎小管間質(zhì)病理?yè)p害評(píng)分采用Katafuchi積分標(biāo)準(zhǔn)。比較PNS患者和正常人間R2*值的差異,分析PNS患者R2*值與腎小管間質(zhì)病理?yè)p害積分、eGFR等臨床指標(biāo)的相關(guān)性,并對(duì)PNS患者的預(yù)后情況進(jìn)行隨訪。結(jié)果 PNS患者髓質(zhì)R2*值明顯低于正常人(t=-9.270,P0.001);PNS患者髓質(zhì)R2*值與eGFR呈負(fù)相關(guān)(r=-0.462,P=0.040),與腎小管間質(zhì)病理?yè)p害積分呈正相關(guān)(r=0.809,P0.001)。隨訪結(jié)果顯示髓質(zhì)R2*值相對(duì)增高的PNS患者預(yù)后常較差。結(jié)論 BOLD MRI能反映PNS患者腎內(nèi)氧合水平及腎功能、病理?yè)p害程度,為評(píng)估PNS患者預(yù)后提供更多輔助信息。
[Abstract]:Objective to evaluate the state of renal oxygen metabolism in patients with primary nephrotic syndrome (PNS) by BOLD MRI. Methods the R2 * values of renal cortex and medulla were measured by BOLD Mr in 20 PNS patients and 18 healthy volunteers. The laboratory indexes such as glomerular filtration rate (GFR) and so on were recorded on the same day of PNS. The biopsy was performed within 1 week after the examination. The score of renal tubulointerstitial lesion was assessed by Katafuchi score. The difference of R2 * between PNS patients and normal subjects was compared. To analyze the correlation between R2 * value and renal tubulointerstitial lesion score (R2 *) in patients with PNS. The prognosis of PNS patients was followed up. Results the medullary R2 * value in PNS patients was significantly lower than that in normal controls. There was a negative correlation between R2 * value and eGFR, and a positive correlation between R2 * value and renal tubulointerstitial lesion score (r0.809 / P0.001). Conclusion BOLD MRI can reflect renal oxygenation level and renal function in PNS patients. The degree of pathological lesion provides more auxiliary information for evaluating the prognosis of PNS patients.
【作者單位】： 浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院放射科;浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院病理科;
【基金】：浙江省自然科學(xué)基金資助項(xiàng)目(LZ16H180001) 浙江省科技廳公益技術(shù)研究社會(huì)發(fā)展項(xiàng)目(2015C33138)
【分類號(hào)】：R445.2;R692
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本文編號(hào)：1613463