论文部分内容阅读
目的 采用体素内不相干运动(IVIM)相关参数值分析紫癜性肾炎(HSPN)和正常儿童肾脏实质之间的差异,探讨IVIM-DWI技术在儿童HSPN诊断和鉴别诊断中的意义.方法 回顾性分析本院17例经肾穿刺活检病理证实为HSPN的患者资料,正常对照组亦取17名正常儿童,两组均顺利完成中腹部常规MR平扫和IVIM-DWI 序列(b值取0、50、100、150、200、400、600 s/mm2)扫描.将扫描原始图像导入IVIM后处理软件,在所得参数标准血流量(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)图像上对两侧肾脏实质区域上极、中部、下极各放置三次感兴趣区(ROI),取其平均值.采用独立样本t检验比较HSPN肾脏与正常肾脏参数值差异.结果 HSPN与正常肾脏IVIM参数BF值在左、右侧下极差异存在统计学意义(P =0.012,0.005)、D值在左、右侧肾脏各部位差异均存在统计学意义(P=0.007,0.002,0.002;0.022,0.045,0.029),D *值则在左、右侧各部位比较均不具有统计学意义,f值在右侧下极中差异存在统计学意义(P =0.000).结论 IVIM参数D值可以作为鉴别HSPN肾脏与正常肾脏的良好参数,BF、f值亦能提供一定参考.IVIM-DWI可以测量正常肾组织与病理情况的血液动力学变化,在反映肾功能状态变化和疾病的鉴别诊断方面具有较高的参考价值.“,”Objective Using intravoxel incoherent motion (IVIM) derived parameters in analysis of the differences in pediatric patients with Henoch-Schonlein purpura nephritis and healthy children kidneys,in order to evaluate the value of IVIM in diagnoses and differentiation.Methods 17 cases and 17 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/mm2.After the original images were imported into the IVIM post-processing software,the ROIs of the left and right renal parenchyma were each set three times.The average value of blood flow (BF),pure molecular diffusion (D),perfusionbased molecular diffusion(D *),perfusion fraction(f) were measured.Evaluate the difference by independent-samples Ttest.Results Comparing IVIM derived parameters of HSPN and healthy kidneys,BF value showed significant difference in the upper part of left and right kidney;f-value showed significant difference in the lower part of left and right renal;while D* was not significantly different.Conclusion IVIM derived parameter D can be used as identification of HSPN kidney and normal kidney;BF,f can also provide some reference.IVIM-DWI 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.