中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
Chinese Journal of Clinicians(Electronic Edition)
2015年
18期
3352-3356
,共5页
赵新尧%孔晓勤%邢可舟%王建宁%门同义%史浩
趙新堯%孔曉勤%邢可舟%王建寧%門同義%史浩
조신요%공효근%형가주%왕건저%문동의%사호
肾移植%移植物排斥%磁共振成像%体素内不相干运动
腎移植%移植物排斥%磁共振成像%體素內不相榦運動
신이식%이식물배척%자공진성상%체소내불상간운동
Kidney transplantation%Graft rejection%Magnetic resonance imaging%IVIM
目的 探讨多b值体素内不相干运动(IVIM)在移植肾急性排斥反应的成像特点及其表观弥散系数(ADC值)、灌注相关弥散系数(D*值)、真实弥散系数(D值)、灌注分数(f值)在移植肾急性排斥反应的诊断价值.方法 回顾性分析2013年12月至2014年9月移植肾急性排斥患者22例为急排组,移植肾稳定患者22例为稳定组,均行3.0 T MR扫描.肾脏IVIM序列采用7个b值,分别测量和比较两组肾脏皮质和髓质的ADC值、D*值、D值和f值.结果 在肾皮质上:急排组ADC值[(1 986±301)×10-6mm2/s]较稳定组ADC值[(2 323±213)×10-6mm2/s]明显降低(P<0.01),急排组D*值(17.27±2.48)较稳定组D*值(19.76±1.45)明显降低(P<0.01),急排组D值(1.87±0.24)较稳定组D值(2.03±0.23)明显降低(P<0.05),急排组f值(17.2±4.99)较稳定组f值(20.1±3.50)明显降低(P<0.05).在肾髓质上:急排组ADC值[(1 865±306)×10-6mm2/s]较稳定组ADC值[(2 076±164)×10-6mm2/s]明显降低(P<0.01),急排组D*值(15.74±3.25)较稳定组(17.55±1.45)明显降低(P<0.05),D值和f值两组间无明显差异.结论 IVIM序列能够定量反映移植肾急性排斥反应的真实弥散和微循环灌注水平,ADC值和D*值在肾皮质降低显著,具有良好的临床应用前景.
目的 探討多b值體素內不相榦運動(IVIM)在移植腎急性排斥反應的成像特點及其錶觀瀰散繫數(ADC值)、灌註相關瀰散繫數(D*值)、真實瀰散繫數(D值)、灌註分數(f值)在移植腎急性排斥反應的診斷價值.方法 迴顧性分析2013年12月至2014年9月移植腎急性排斥患者22例為急排組,移植腎穩定患者22例為穩定組,均行3.0 T MR掃描.腎髒IVIM序列採用7箇b值,分彆測量和比較兩組腎髒皮質和髓質的ADC值、D*值、D值和f值.結果 在腎皮質上:急排組ADC值[(1 986±301)×10-6mm2/s]較穩定組ADC值[(2 323±213)×10-6mm2/s]明顯降低(P<0.01),急排組D*值(17.27±2.48)較穩定組D*值(19.76±1.45)明顯降低(P<0.01),急排組D值(1.87±0.24)較穩定組D值(2.03±0.23)明顯降低(P<0.05),急排組f值(17.2±4.99)較穩定組f值(20.1±3.50)明顯降低(P<0.05).在腎髓質上:急排組ADC值[(1 865±306)×10-6mm2/s]較穩定組ADC值[(2 076±164)×10-6mm2/s]明顯降低(P<0.01),急排組D*值(15.74±3.25)較穩定組(17.55±1.45)明顯降低(P<0.05),D值和f值兩組間無明顯差異.結論 IVIM序列能夠定量反映移植腎急性排斥反應的真實瀰散和微循環灌註水平,ADC值和D*值在腎皮質降低顯著,具有良好的臨床應用前景.
목적 탐토다b치체소내불상간운동(IVIM)재이식신급성배척반응적성상특점급기표관미산계수(ADC치)、관주상관미산계수(D*치)、진실미산계수(D치)、관주분수(f치)재이식신급성배척반응적진단개치.방법 회고성분석2013년12월지2014년9월이식신급성배척환자22례위급배조,이식신은정환자22례위은정조,균행3.0 T MR소묘.신장IVIM서렬채용7개b치,분별측량화비교량조신장피질화수질적ADC치、D*치、D치화f치.결과 재신피질상:급배조ADC치[(1 986±301)×10-6mm2/s]교은정조ADC치[(2 323±213)×10-6mm2/s]명현강저(P<0.01),급배조D*치(17.27±2.48)교은정조D*치(19.76±1.45)명현강저(P<0.01),급배조D치(1.87±0.24)교은정조D치(2.03±0.23)명현강저(P<0.05),급배조f치(17.2±4.99)교은정조f치(20.1±3.50)명현강저(P<0.05).재신수질상:급배조ADC치[(1 865±306)×10-6mm2/s]교은정조ADC치[(2 076±164)×10-6mm2/s]명현강저(P<0.01),급배조D*치(15.74±3.25)교은정조(17.55±1.45)명현강저(P<0.05),D치화f치량조간무명현차이.결론 IVIM서렬능구정량반영이식신급성배척반응적진실미산화미순배관주수평,ADC치화D*치재신피질강저현저,구유량호적림상응용전경.
Objective To investigate the features and diagnostic value of intravoxel incoherent motion (IVIM) MR imaging of acute rejection after kidney transplantation.Methods 22 patients with acute renal allograft rejection confirmed by pathology or clinic, 22 patients with stable graft function were retrospectively reviewed from Dec.2013 to Sep.2014. IVIM sequence was performed with 7 b values between 0 and 600 s/mm2. The apparent diffusion coefficient (ADC), the diffusion coefficient of microcirculation or perfusion (D*), the diffusion coefficient of pure molecular diffusion (D), and perfusion fraction (f) were measured and compared between the two groups.Results In renal cortex: ADC value of the acute rejection group (1 986±301)×10-6mm2/s was significantly lower (P<0.01) than that in the stable graft function group (2 323±213)×10-6mm2/s, D* value of the acute rejection group (17.27±2.48) was significantly lower (P<0.01) than that in the stable graft function group (19.76±1.45), D value of the acute rejection group (1.87±0.24) was significantly lower (P<0.05) than that in the stable graft function group (2.03±0.23), f value of the acute rejection group (17.2±4.99) was significantly lower (P<0.05) than that in the stable graft function group (20.1±3.50). In renal medulla: ADC value of the acute rejection group (1 865±306)×10-6mm2/s was significantly lower (P<0.01) than that in the stable graft function group (2 076±164)×10-6mm2/s, D* value of the acute rejection group (15.74±3.25) was significantly lower (P<0.05) than that in the stable graft function group (17.55±1.45), D and f values of the medulla were not significantly different between the two groups.Conclusion IVIM can represent the perfusion and true diffusion levels of the acute renal allograft rejection, ADC and D* values of the acute rejection group were significantly lower in the renal cortex. The IVIM has strong practicality and favorable clinical prospects.
