CAJ | 학술논문

目的探讨磁共振扩散加权成像（DWI）及灌注成像（PWI）在观察糖尿病肾病的诊断价值。方法行磁共振DWI检查的50例糖尿病肾病患者，行磁共振肾脏PWI检查的17例糖尿病肾病患者资料，行磁共振DWI检查的健康对照者20名，行磁共振PWI的健康对照者15名，所有检查者均行磁共振常规平扫，然后行磁共振DWI检查及PWI检查。结果Ⅰ~Ⅱ期的糖尿病肾病患者的肾脏表观扩散系数（ADC）值与健康对照者肾脏的ADC值差异无统计学意义，Ⅲ~Ⅴ期的糖尿病肾病患者的肾脏ADC值较健康对照者肾脏的ADC值低，差异有统计学意义，而且Ⅴ期的糖尿病肾病患者的肾脏ADC值较Ⅳ期的低，Ⅳ期的糖尿病肾病患者的肾脏ADC值较Ⅲ期的低。Ⅰ~Ⅱ期的糖尿病肾病患者的肾脏的时间-信号曲线与健康对照者相近，皮质信号峰值（Pc）、髓质信号峰值（Pm）及皮质达峰时间（Tc）和髓质达峰时间（Tm）差异无统计学意义。Ⅲ~Ⅴ期的糖尿病肾病肾脏的时间-信号曲线呈缓慢上升，曲线低平，曲线峰值也明显下降。Pc、Pm降低，Tc和Tm延迟。结论磁共振DWI和PWI能够反映糖尿病肾病患者的肾脏功能变化。
목적탐토자공진확산가권성상（DWI）급관주성상（PWI）재관찰당뇨병신병적진단개치。방법행자공진DWI검사적50례당뇨병신병환자，행자공진신장PWI검사적17례당뇨병신병환자자료，행자공진DWI검사적건강대조자20명，행자공진PWI적건강대조자15명，소유검사자균행자공진상규평소，연후행자공진DWI검사급PWI검사。결과Ⅰ~Ⅱ기적당뇨병신병환자적신장표관확산계수（ADC）치여건강대조자신장적ADC치차이무통계학의의，Ⅲ~Ⅴ기적당뇨병신병환자적신장ADC치교건강대조자신장적ADC치저，차이유통계학의의，이차Ⅴ기적당뇨병신병환자적신장ADC치교Ⅳ기적저，Ⅳ기적당뇨병신병환자적신장ADC치교Ⅲ기적저。Ⅰ~Ⅱ기적당뇨병신병환자적신장적시간-신호곡선여건강대조자상근，피질신호봉치（Pc）、수질신호봉치（Pm）급피질체봉시간（Tc）화수질체봉시간（Tm）차이무통계학의의。Ⅲ~Ⅴ기적당뇨병신병신장적시간-신호곡선정완만상승，곡선저평，곡선봉치야명현하강。Pc、Pm강저，Tc화Tm연지。결론자공진DWI화PWI능구반영당뇨병신병환자적신장공능변화。
Objective To investigate the renal function of diabetic nephropathy patients by using magnetic resonance(MR) diffusion weighted imaging(DWI) and MR perfusion imaging(PWI), and to evaluate the role of DWI and PWI in diagnosis of early renal dysfunction in patients with diabetic nephropathy. Methods Fifty diabetic nephropathy and 20 check-up subjects (healthy control group) were checked using DWI. Seventeen diabetic nephropathy patients and 15 check-up subjects were checked using PWI. Single-shot echo planar image DWI,dynamic enhanced MRI scanning and routine MR sequence scan were used to measure bilateral kidneys in these patients or healthy subjects. Results The ADC values of the phaseⅠof the diabetic nephropathy group and phase Ⅱ of the diabetic nephropathy group had no significant difference comparing with healthy control group , the ADC values of phaseⅢ-Ⅴ of the diabetic nephropathy groups were significantly lower than those in healthy control group and the phaseⅠ-Ⅱ of thediabetic nephropathy groups. Mean peak intensity value and the P/T time to peak ratio at the cortex and medulla of phaseⅠ-Ⅱ of the diabetic nephropathy groups were no significant difference comparing with healthy control group (all P>0.05), but phase Ⅲ-Ⅴof the diabetic nephropathy groups were significantly lower than those in healthy control group and the phaseⅠ-Ⅱ of the diabetic nephropathy groups. Conclusion DWI and PWI may be more useful in identifying early renal dysfunction in patients with diabetic nephropathy.