CAJ | 학술논문

目的探讨正常肾脏及常见肾脏疾病MR灌注加权成像(PWI)的主要表现特征和临床应用价值.方法搜集共31例患者行MR PWI,其中9例非泌尿系统疾病患者作为正常肾对照组,肾癌14例,肾囊肿6例,肾结核2例.31例均行冠状面常规T1WI、T2WI与PWI.原始图像经工作站处理后获得灌注曲线及各功能图像,比较正常肾脏及病变部位的时间-信号强度曲线、血容量(RBV)、血流量(RBF)、平均通过时间(MTT)、达峰值时间(TTP)及相应灌注功能图像.正常肾脏灌注参数(RBV、RBF、MTT和TTP)的相对值通过左肾/右肾获得,异常肾脏灌注参数通过病变组织/对侧同一部位肾组织获得.观察两组肾脏的血流灌注参数变化,并结合灌注图像对其病变组织的血流变化进行分析.对正常对照组左、右肾和正常肾皮、髓质各灌注参数的比较采用t检验;对异常肾与正常肾各灌注参数的比较行q检验.结果正常肾脏皮质的相对RBV(1.33±0.08)和RBF(1.44 ±0.09)均明显大于髓质相对RBV(0.58 ±0.05)和相对RBF(0.78 ±0.13),差异均有统计学意义(t值分别为9.2241和5.0336,P值均＜0.01);肾脏皮质相对MTT(1.11±0.08)和相对TTP(1.04 ±0.06)与髓质相对MTT(0.97±0.04)和相对TTP(0.94±0.03)差异无统计学意义(t值分别为2.2551和2.2613,P值均＞0.05).肾癌相对RBF(1.35±0.34)明显高于正常肾脏组织相对RBF(1.02±0.06)(q=3.0882,P＜0.01).结论 PWI可以测量正常肾组织与病理情况的血液动力学变化,在肾功状态变化和疾病的鉴别诊断方面具有较高的应用价值.
목적 탐토정상신장급상견신장질병MR관주가권성상(PWI)적주요표현특정화림상응용개치.방법 수집공31례환자행MR PWI,기중9례비비뇨계통질병환자작위정상신대조조,신암14례,신낭종6례,신결핵2례.31례균행관상면상규T1WI、T2WI여PWI.원시도상경공작참처리후획득관주곡선급각공능도상,비교정상신장급병변부위적시간-신호강도곡선、혈용량(RBV)、혈류량(RBF)、평균통과시간(MTT)、체봉치시간(TTP)급상응관주공능도상.정상신장관주삼수(RBV、RBF、MTT화TTP)적상대치통과좌신/우신획득,이상신장관주삼수통과병변조직/대측동일부위신조직획득.관찰량조신장적혈류관주삼수변화,병결합관주도상대기병변조직적혈류변화진행분석.대정상대조조좌、우신화정상신피、수질각관주삼수적비교채용t검험;대이상신여정상신각관주삼수적비교행q검험.결과 정상신장피질적상대RBV(1.33±0.08)화RBF(1.44 ±0.09)균명현대우수질상대RBV(0.58 ±0.05)화상대RBF(0.78 ±0.13),차이균유통계학의의(t치분별위9.2241화5.0336,P치균＜0.01);신장피질상대MTT(1.11±0.08)화상대TTP(1.04 ±0.06)여수질상대MTT(0.97±0.04)화상대TTP(0.94±0.03)차이무통계학의의(t치분별위2.2551화2.2613,P치균＞0.05).신암상대RBF(1.35±0.34)명현고우정상신장조직상대RBF(1.02±0.06)(q=3.0882,P＜0.01).결론 PWI가이측량정상신조직여병리정황적혈액동역학변화,재신공상태변화화질병적감별진단방면구유교고적응용개치.
Objective To explore the characteristics and the clinical application of MR perfusion weighted imaging(PWI)in the normal kidneys and the renal diseases.Methods Thirty-one subjects including 9 cases without urinary diseases,14 cases with renal carcinoma,6 cases with renal cyst and 2 cases witll renal tuberculosis who had been examined with T1WI,T2WI and PWI were analyzed retrospectively.All the data were processed by a workstation to obtain time-signal intensity curves,color perfusion maps and relative perfusion value.The relative renal blood volume(RBV),relative renal blood flow(RBF),mean transition time(MTT)and the time to peak(TTP)in the normal renal cortex and medulla and the renal lesions were calculated.Comparisons between the right and the left normal kidneys,and between the cortex and the medulla of the normal kidneys were performed using t test,and comparisons between the normal and the abnormal kidneys were performed using q test.Results Relative RBV and relative RBF of the cortex were 1.33±0.08 and 1.44±0.09 respectively,and for medulla were 0.58±0.05 and 0.78±0.13 respectively(t=9.2241 and 5.0336,P＜0.01);MTT(1.11±0.08)and TTP (1.04±0.06)of the cortex has no difference with that of the medulla(0.97±0.04 and 0.94±0.03)in the normal kidneys(t=2.2551 and 2.2613.P＞0.05).The values of relative RBF of the renal carcinoma (1.35±0.34)were significantly higher than that of the normal tissues(1.02±0.06)(q=3.0882,P＜0.01).Conclusion PWI is able to demonstrate the hemodynamic change of the normal renal tissues and the renal lesions,and it maybe an ideal method for showing the functional changes of the kidney and for differentiating the renal diseases.