| Objective:To explore the application value of functional magnetic resonance imaging in thediagnosis of renal insufficiency(RI),classification renal insufficiency in different gradingand evaluation of renal artery stenosis, including two parts, the first part is blood oxygenlevel dependent functional imaging(BOLD), the second part is inflow inversion recoverfast imaging employing steady-state acquisition (IFIR-FIESTA).Material and Methods:Select55patients who came from Department of Internal Medicine Clinic ofShandong Provincial Hospital with renal insufficiency from2013January to2014February.According to the patient’s renal function testing laboratory serum creatinine level in the list(Scr) to calculate the estimated glomerular filtration rate(eGFR),then to determine thegrade of renal insufficiency patients.There were35males and30females, average age is43.5years old.At the same time,15healthy volunteers who were randomly selected fromage and sex matched group were enrolled in the examination.Using3.0T GE Signa superconducting magnetic resonance scanner (General ElectricCompany in USA),8channel phased array scanning sequence coil, subjects wereexamination including: coronal T2WI sequence, axial FS-T2WI, axial FS-T1WI weightedsequence,sagittal T2WI sequence,R2*map sequence of oblique coronal and axial3D layerblock respiratory triggered IFIR-FIESTA sequence.All sequences scanned,(1)using the R2STAR program generating image on ADW4.5workstation provided by GE, placed12ROIs in bilateral upper pole, body, lower pole ofcortex and medulla respectively in mannal, measure and calcullate R2*value in patientswith renal insufficiency and the control group,①compare the R2*value between thegroups of renal cortex and medulla in the matched group, compare the R2*of cortex andmedulla in different grade group;②correlation analysis was carried out on cortex,medulla,cortex and medulla R2*value analysis and different grade group with renal insufficiency patients.(2)using Reformat processing software to reconstruct images, measure renal arterydiameters with bilateral renal artery of different grade of renal insufficiency patients, renalartery stenosis level of different stages of renal insufficiency patients and the correlationbetween classification and renal function were analyzed.Result:(1)Different grade of renal insufficiency patients number were11,9,12,13,10,andnormal control group was15cases.①In control group,R2*value of the medulla wassignificantly greater than that of cortex(P<0.05).There were significant differences betweenR2*value of the normal control group and different grades of renal insufficiency patientswith cortical, medullary and cortical/medulla(P<0.05).②In the patients with renalinsufficiency, R2*value of cortex,medulla and cortex/renal were in the oppositerelationship with renal insufficiency level(P<0.05).(2)All of the above cases,average diameters of renal artery of different renalinsufficiency grade were5.82mm,5.08mm,4.44mm,4.21mm,4.02mm, thus averagediameters of renal artery of normal control group was6.78mm. The stenosis degree of renalartery of renal insufficiency has the positive proportion with the renal function.Conclusion:①The first part, the use of renal blood oxygenation level dependent(BOLD) sequencecan be obtained normal renal medullary oxygenation level than the cortex. R2*values ofmedulla/cortical could not only differentiate renal insufficiency patients with normalkidney kidney, but also can distinguish patients between different levels of renalinsufficiency, It can reflect the changes of renal function sensitively and play an importantrole in the diagnosis and staging of renal insufficiency;②T he second part,usingIFIR-FIESTA sequences could show renal artery imaging clearly, could be a very gooddetection of renal artery stenosis. It can provide the objective basis for clinical diagnosisand scientific research on renal artery stenosis of patients with renal insufficiency. |
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