Application Of BOLD MRI Imaging And DWI In Chronic Kidney Disease

PurposeThis study aims to research Blood oxygen level dependent (BOLD) MRIand.Diffusion-weigh MR imaging(DWI) of kidneys.We try to discuss the relationshipbetween ADC values and R2*values of bilateral renal cortex and medulla,and kidneystructure and function changs of the patients with chronic kidney disease (CKD).We alsotry to explore,as new methods, oxygen level dependent MRI and Diffusion-weigh MRimaging have significant clinical value in the diagnonsis and prognosis of kidney disease.Materials and methodsWe used Blood oxygen level dependent MRI and.Diffusion-weigh MR imaging toscan68cases during December,2012-December2013.19cases are healthy controls. Weselect a total of49patients with chronic kidney disease, including kidney biopsy26people,according to the patients with CKD stage will be divided into two subgroups. Recordsscanning the object’s gender, age, weight, serum creatinine and urea nitrogen, through theCG formulas to calculate the eGFR, and collect the morning urine albumin excretionrate,CysC and urine creatinine, and renal biopsy in patients with semi-quantitative method:using single pathological damage integral to the pathological integral of nine pathologicalindex, are all0to3.We used3.0T MRI scanner to scan all subjects.Positioning as: transection, coronaland sagittal bits; conventional MRI sequence: T2WI transection and coronary position,T1WI transection, spin echo sequence; BOLD imaging sequence: coronary, for many timesthe gradient echo sequences, DW: b value of800s/mm2. Used in the process of scanningSENSE coil of Cardiac and respiratory gating technique. BOLD sequence scanningpatients need to hold their breath16s. We used SPSS17.0software package to analyze all the data.All measurement data areboth normal distribution and constant variances,.We show the results with the mean+/-standard deviation. We used avariance analysis and t text to compare the differencebetween subgroups in cortex and medulla ADC values and the R2*value of kidneys.Andwe try to dissuss the telationship between differences and the relationship between cortexand medulla ADC values and the R2*value of kidneys,and some of correlative factor byusing analysis of variance, Pearson correlation analysis and Spearman correlation analysis(P <0.05for the difference was statistically significant.)Consequence1、 The cortex ADC values of the control group and group with CKD weresignificantly higher than that of medulla ADC value(P<0.05);2groups of cortical R2*values were significantly less than the medulla.(P<0.05) Control group left kidney skinhad no difference between the medulla ADC values(P>0.05); Medulla ADC values and R2*values of Left and right sides of the kidney in2groups were no significantdifference(P>0.05).2、The CKD group and normal group of renal cortical ADC values and R2*valuecomparison, the difference was statistically significant(P<0.05); The CKD group andnormal group of renal medulla ADC values and R2*value comparison, the difference wasstatistically significant(P<0.05).3、Control group medullary ADC values and R2*value with early renal damage andmiddle-late stage renal impairment group comparison, difference have statisticalsignificance(P<0.05); early renal damage group compared with group of middle-lateimpaired renal function, ADC values of cortex and R2*value of medulla between the2group was statistically significant(P<0.05); ADC values of medulla and cortical of R2*value had no statistically significant difference(P>0.05).4、ADC values of renal cortical was negatively correlated with creatinine, urea, andeGFR were positively correlated (r=-0.14,-0.27,0.35,P<0.05); R2*value of cortical wasnegatively correlated with urinary albumin/urinary creatinine (r=-0.4,P<0.05); R2*value of medulla was negatively correlated with urea, creatinine, urine CysC, and eGFR werepositively correlated(r=-0.39,-0.48,0.21,-0.34,P<0.05).5、ADC values of cortex of the patients of renal biopsy was negatively correlated withmesangial cell proliferation, balloon/body small crescent, renal tubular atrophy andinterstitial inflammatory cell infiltration, interstitial fibrosis, small artery lesions,they allhad statistical significance (r=-0.44,-0.55,-0.41,-0.55,-0.55,-0.4,P<0.05); R2*value ofcortical and mesangial cell proliferation were positively correlated(r=0.47,P<0.05).Conclusion1、Blood oxygen level dependent MRI and Diffusion-weigh MR imaging of kidneyscan display the difference between renal cortex and medulla, which can reflect kidney skin,medullary function.2、Measuring kidney ADC values and R2*values can be used as the basis of chronickidney disease in early diagnosis;3、Renal cortical ADC values can be used as a non-invasive assessment of renalfunction,and monitoring of patients with chronic kidney disease progression, and judgmentof the important methods for therapeutic effect;4、Renal medulla R2*value with cortical R2*value, can comprehensively evaluatethe glomerulus and renal tubule interstitial lesions, and investigate kidney progressnoninvasively;5、Blood oxygen level dependent MRI and.Diffusion-weigh MR imaging of kidneyscan comprehensively evaluate the renal function and pathological changes of chronickidney disease in the future.there may be a very important role in diagnosis and treatment.