体素内不相干运动参数值评价正常儿童肾脏皮髓质差异-东南大学学报医学版

体素内不相干运动参数值评价正常儿童肾脏皮髓质差异

作者：邢春华¹ 万红燕² 陈静雯² 赵丽萍³ 华妙强² 吴晴³ 陈宏伟² 徐蒙莱² 姜新宇²

单位：1. 南京医科大学附属南京医院医学影像科, 江苏南京 210006;
2. 无锡市儿童医院医学影像科, 江苏无锡 214023;
3. 无锡市儿童医院肾内科, 江苏无锡 214023

分类号：R445.2

出版年·卷·期（页码）：2016·35·第六期（996-1001）

摘要：

目的：探讨体素内不相干运动（IVIM）相关参数值在正常儿童肾脏皮髓质之间的差异，为儿童肾脏病变在磁共振（MR）IVIM-DWI成像时提供正常参考值。方法：28例健康志愿者均行中腹部常规MRI平扫和IVIM-DWI检查，b值取0、50、100、150、200、400、600 s·mm^-2。将扫描原始图像导入IVIM后处理软件，对左、右侧肾皮质及髓质分别划取3个像素大小为10~15的ROI，测量皮髓质血流量（BF）、体素内真性水分子扩散（D）、体素内微循环灌注（D^*）、灌注分数（f）值，取3次的平均值。采用独立样本t检验评价IVIM各参数在皮髓质之间的差异；采用ROC曲线分析BF、D、D^*、f值区分差异的效能。结果：28例正常儿童肾脏中：皮髓质BF值分别为（3.47±0.35）×10^-3、（3.28±0.23）×10^-3 mm²·s^-1；D值分别为（2.70±0.13）×10^-3、（2.12±0.31）×10^-3 mm²·s^-1，D^*值分别为（15.06±1.10）×10^-3、（14.23±0.73）×10^-3 mm²·s^-1；f值分别为（26.13±4.07）%和（32.11±3.50）%。肾脏皮质D、D^*值明显高于髓质，而肾脏皮质的f值则低于髓质，差异均具有统计学意义（P=0.000、0.027、0.001）。肾脏皮、髓质BF值差异无统计学意义（P=0.109）。ROC分析得到BF、D、D^*、f值曲线下面积分别为0.622、0.954、0.760、0.872（P=0.270、0.000、0.019、0.001）。结论：IVIM相关参数D、D^*、f值在肾脏皮髓质中存在显著差异，其中D值区分差异的能力最强；而BF值在肾脏皮髓质之间的差异无统计学意义。

Objective: To evaluate the value of intravoxel incoherent motion(IVIM) derived parameters in differentiating renal cortex and medulla of healthy children, in order to provide normal reference in renal diseases. Methods: 28 healthy volunteers underwent middle abdomen 1.5 T MR(including conventional MRI and IVIM-DWI scan sequences), and b values were 0, 50, 100, 150, 200, 400, 600 s·mm^-2. After the original images were imported into the IVIM post-processing software, the ROIs of the left and right renal cortex and medulla were each set three times. The average value of blood flow(BF), pure molecular diffusion(D), perfusion-based molecular diffusion(D^*), perfusion fraction(f) were measured. Using independent-samples t test to evaluate the difference and using ROC analysis to compare the differential potential of parameters BF, D, D^*, f. Results: BF values of cortex and medulla in 28 cases of healthy volunteers were(3.47±0.35)×10^-3 mm²·s^-1 and(3.28±0.23)×10^-3 mm²·s^-1 separately, D values were(2.70±0.13)×10^-3 mm²·s^-1 and(2.12±0.31)×10^-3 mm²·s^-1, D^* values were(15.06±1.10)×10^-3 mm²·s^-1 and(14.23±0.73)×10^-3 mm²·s^-1, f values were(26.13±4.07)% and(32.11±3.50)%. D, D^* and f values were significantly different in renal cortex and medulla(P=0.000, 0.027, 0.001, respectively). BF was not significantly different(P=0.109). Areas under the ROC curve for the related parameters BF, D, D^*, f were 0.622, 0.954, 0.760, 0.872(P=0.270, 0.000, 0.019, 0.001), respectively. Conclusion: D, D^*, f value show significant difference in renal cortex and medulla, and the differential potential of D is the highest, and BF shows poor difference in cortex and medulla.

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