The Study Of Functional Magnetic Resonance Imaging In Lupus Nephritis Patients

Part one Renal blood oxygen level dependent magnetic resonance imaging Of lupus nephritis patientsObjective: Appropriate clinical treatment and suitable evaluation prognosis dependent on renal pathophysiological real-time precise description in patients with lupus nephritis.Blood oxygen level dependent(BOLD)magnetic resonance imaging(MRI)can provide tissue oxygenation information in kidneys.The aim of this study is to develop algorithm models by using BOLD-MRI parameters for prediction renal pathological patterns.We will also explore the relationship between renal parenchyma oxygenation and renal pathological indexes.Methods: Adult lupus nephritis patients and healthy controlled participants with comparable age and gander were recruited in this study.Lupus nephritis patients were positively diagnosed by experiment nephrologists according to 2012 International Collaborating Clinics classification criteria for systemic lupus erythematosus.BOLDMRI images were acquired from lupus nephritis patients and healthy controlled participants by using GE Discovery 750 3.0 T magnetic resonance system.Functional reconstruction software Functool and post processor software R2* maps were used to generate renal R2* images.R2* values and gray level co-occurrence matrix(GLCM)parameters of region of interest(ROI)were measured by Math Works Matlab 2015 a software.After we processed these R2* values by statistics and data mining software,there algorithm models including decision tree,Fisher's linear discriminant formula and logistic regression were constructed in order to predict renal pathological patterns.Subsequently,we also compared the predictive capability of three models.Multiple correspondence analysis(MCA)correlative map of renal R2* values and pathological parameters was also plotted.Results: The area under the ROC curve of the decision tree model was greater than those of the line discriminant model(0.765 vs 0.629,P<0.001)and logistic regression model(0.765 vs 0.662,P<0.001).Two GLCM parameters including correlation andenergy revealed differences in renal pathological patterns.The accuracy rate of renal pathological patterns prediction by Fisher's line discriminant formulas was 77.8%.Renal R2* value analysis showed that means of R2* values in V type patients(24.291±2.482)were higher than III type(19.576±2.854,p<0.001),IV type(20.284±3.857,p<0.001).MCA analysis revealed that higher R2* values correlated with mild renal tubular and interstitial injury and older age.Conclusions: BOLD MRI is a useful imaging technique for evaluating renal oxygenation status.There is a probability of developing algorithm model for prediction renal pathological patterns by using BOLD-MRI parameters and image characteristics.A sophisticated non-line relationship between tissue oxygenation and pathological injury in lupus nephritis kidneys.Part Two Diffusion weighted imaging magnetic resonance imaging Of lupus nephritis patientsObjective: Histolopathological injury can lead to abnormal movement manner of water molecule in lupus nephritis kidneys.Diffusion weighted imaging(DWI)magnetic resonance imaging(MRI)technique can provide water molecule movement information in renal cells and tissue.The aim of this study is to understand water molecule mode of motion and evaluate pathophysiological status by means of DWIMRI technique in lupus nephritis patients and healthy controlled participants.Methods: Adult lupus nephritis patients and healthy controlled participants with comparable age and gander were recruited in this study.Lupus nephritis patients were positively diagnosed by experiment nephrologists according to 2012 International Collaborating Clinics classification criteria for systemic lupus erythematosus.DWIMRI images were acquired from lupus nephritis patients and healthy controlled participants by using GE Discovery 750 3.0 T magnetic resonance system.Functional reconstruction software Functool and post processor software MADC were used to generate renal apparent diffusion coefficient(ADC)values,D values,D* values and fvalues images.Levels of ADC,D,D* and f values of region of interest(ROI)were measured by Math Works Matlab 2015 a software.Comparison of these parameters between lupus nephritis patients and healthy controlled participants as well as among the different pathological type of lupus nephritis patients were accomplished.Multiple correspondence correlation between DWI parameters and different pathological characteristics was also analyzed.Results: Renal DWI parameters value analysis showed that means of ADC values in cortical region were higher than that in medullary region(2.393 ± 0.085 vs 2.358 ±0.067 ? 10-3mm2/s,P=0.002)and similar results were found in f values(23.949 ± 0.321 vs 23.530 ± 0.735 %,P<0.001)in healthy controlled participants group.No statistics difference were found among parameter D value and D* values.The means of D values in cortical region were higher than that in medullary region(1.677 ± 0.314 vs 1.597 ±0.348 ? 10-3mm2/s,P=0.03)and opposite results were found in D* values(22.391 ±1.979 vs 23.079 ± 1.333 ? 10-3mm2/s,P<0.001)in lupus nephritis patients group.No statistics difference were found among parameter ADC value and f values.Compared with healthy controlled participants group,higher renal cortical and medullary DWI parameters values were found in lupus nephritis patients group except for D* parameter were found lower values.There were different magnitude discrepancy DWI parameters values among the different pathological type of lupus nephritis patients.MCA analysis revealed that there was correlation between DWI parameters and degree of renal histopathological injury.Conclusions: DWI-MRI is a useful imaging technique for evaluating renal tissue water molecule motion characteristics.The renal water molecule movement manner were changed in lupus nephritis patients.We may understand the category and degree of renal histopathological injury by means of measurement renal water molecule motion indexes.