The Research On The Value Of The Application Of Magnetic Resonance Kurtosis Diffusion Imaging In Diabetic Nephropathy

Objective: Had patients with diabetic nephropathy and healthy volunteers examed by MRI with DKI technology,obtained the values and pseudo color maps of mean kurtosis(MK)?radial kurtosis(K?)and axial kurtosis(K?),discussed the changes in MK values?K? values?K?values in the cortex and medulla of kidneys in different periods of diabetic nephropathy,analysed the correlation between each parameter value and UAER,with a hope to provide an effective imaging basis to the diagnosis of DN.Methods:Twelve patients with diabetic nephropathy were selected as the observation group.According to the results of urinary album in excretion rate(UAER),7 patinets were divided into DN in early-stage group,DN in advanced-stage were 5 patients,11 healthy volunteers were selected for the control group,the observation group and the control group were all examed by 3.0T magnetic resonance with DKI technology,the diffusion gradient factor(b value)were(0 1000s/mm2 2000s/mm2),resulted the pseudo color maps of MK,K?and K?.For each subject,12 areas of interest were drawn in the upper pole,middle pole and lower pole of cortex and medulla in the left kidney and right kidney,got the average.Compared the MK values,K?values and K? values of medulla and cortex between the left kidney and right kidney,as well as the difference between the control group and the patients in different stages of diabetic nephropathy.Analysed the diagnostic efficacy between the control group and the patients in early-stage of DN group,the patients in early-stage of DN group and the patients in advanced-stage of DN group with the ROC curve of MK values in cortex.Analysed the correlation between these measured values and UAER.Results: No statistically significant difference was observed between the left and right kidneys for all metrics and cortexs in both the control group and the observation group(P <0.05).The MK values,K?values and K? values in both medulla and cortex were increased with the progress of DN,and the measured values in cortex were statistically significant;The MK values,K?values and K?values in the cortex of the control group were lower than those in the early-stage of DN group(p <0.05),the MK values and K?values of cortex in the early-stage of DN group were lower than those in the advanced-stage of DN group(p<0.05),there were no significantly different between the adjacent group in the measured values of medulla.For the identification between control group and early-stage of DN group,early-stage of DN group and advanced-stage of DN group,the MK values of cortex had a higher accuracy(AUC> 0.8).The MK values,K?values and K? values of the cortex were positively correlated with UAER,and there were no significant correlation in the measured values of the medulla.Conclusion:(1)DKI technology is feasible for examining diabetic nephropathy.(2)The early damage of diabetic nephropathy can be showed by the MK values of cortex of DKI,and there has a certain reference value for the identification of difference stage of diabetic nephropathy.(3)The measured values of cortex of DKI have a significant correlation with UAER,can monitor the progress of diabetic nephropathy.