| Objective:1.To establish the reference range and evaluation system of the normal renal ADC values and R2* values by completing the diffusion-weighted imaging and the blood oxygenation level-dependent imaging of the healthy volunteers.2.To investigate the capacity of the diffusion-weighted imaging and the blood oxygenation level-dependent imaging for identifying the grade of Ig A nephropathy by comparing the ADC values between the control group and the Ig AN group.3.To investigate the application value of the functional magnetic resonance imaging in evaluating the renal filtration function and the pathological damage of Ig A nephropathy by analysing the correlation between the ADC / R2* values and GFR, Katafuchi scores. Methods:Thirty-five patients with Ig A nephropathy which were confirmed by renal biopsy were enrolled in this study from January 2014 to December 2014. The patients with nephrarctia, hydronephrosis, nephrolithiasis were eliminated. The glomerular filtration rate were calculated with 99Tcm-DTPA scintigraphy. According to the Lee classification, Ig A nephropathy were divided into I-V grade. Using the Katafuchi system to get the scores of the pathological damage of Ig A nephropathy. The control group was composed of twenty healthy volunteers matched for sex and age. All of the subjects should stop drug therapy, fast food and water before the examinations, then underwent studies on 3.0T MR scanner with respiratory gating technique and surface phased array coils. The first step were conventional T1 WI and T2 WI examinations. The second step were DWI with SE-EPI sequence and BOLD with m GRE sequence. Finally, post-processing the datas to obtain the ADC values and R2* values of the renal cortical and medulla. Data analysis: 1.To compare the ADC values, R2* values between the renal cortical and medulla; 2. To compare the ADC values, R2* values between the control group and different grade of Ig A nephropathy group; 3.To analyse the correlation between the ADC / R2* values and GFR; 4. To analyse the correlation between the ADC / R2* values and Katafuchi scores. Results:There were 20 healthy volunteers in the control group, 3 cases of Ig A nephropathy I, 21 cases of Ig A nephropathy III and 11 cases of Ig A nephropathy IV.1.The renal cortical ADC values were higher than medulla in both the control group and the Ig A nephropathy group(p<0.05). The renal cortical and medulla ADC values of the control group, Ig AN I group, Ig AN III group, Ig AN IV group were 2.61±0.09 vs 2.37±0.07、2.57±0.08 vs 2.19±0.08、2.35±0.12 vs 2.08±0.06、2.13±0.23 vs 1.86±0.15,respectively. There was a statistically significant difference in renal cortical and medulla ADC values between the control group and the Ig A nephropathy group(p<0.05).But there was no significant difference in renal cortical ADC values between Ig AN I group and the control group(p>0.05).2.There was a positive correlation between the renal cortical and medulla ADC values and the GFR values(p<0.05).Negative correlation was found between the renal cortical and medulla ADC values and the Katafuchi scores(p<0.05).3. The renal medulla R2* values were higher than cortical in both the control group and the Ig A nephropathy group(p<0.05). The renal cortical and medulla ADC values of the control group, Ig AN I group, Ig AN III group, Ig AN IV group were 16.23±1.15 vs 31.22±1.44、17.29±0.52 vs 32.58±0.69、18.60±1.00 vs 35.25±1.13、19.43±0.80 vs 38.68±1.64,respectively. There was a statistically significant difference in renal cortical and medulla R2* values between the control group and the Ig A nephropathy group(p<0.05).But there was no significant difference in renal cortical and medulla R2* values between Ig AN I group and the control group(p>0.05).4. There was a negative correlation between the renal cortical and medulla R2* values and the GFR values(p<0.05). Positive correlation was found between the renal cortical and medulla R2* values and the Katafuchi scores(p<0.05). Conclusions:1. Functional magnetic resonance imaging could reflect the physiological functions of the kidney, which showed the difference of ADC values、R2* values between the renal cortex and medulla.2.There were obvious difference on the ADC values and the R2* values between the healthy people and the Ig A nephropathy patients. That meant functional magnetic resonance imaging was feasibility for detecting kidney diseaseas.3.As the grade of Ig A nephropathy increased, there was a downward trend of ADC values and an upward trend of R2* values. That meant functional magnetic resonance imaging had certain clinical values for identifying the grade of Ig A nephropathy.4.As GFR of Ig A nephropathy decreased, there was a downward trend of ADC values and an upward trend of R2* values. That meant functional magnetic resonance imaging could be used for assessing the renal filtration function.5.As the Katafuchi scores of Ig A nephropathy increased, there was a downward trend of ADC values and an upward trend of R2* values. That meant functional magnetic resonance imaging was expected to become a noninvasive method for evaluating the pathological damage of Ig A nephropathy. |
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