| Part ?.A Comparative study between different field strengths in the IVIM-DWI of kidneys in healthy adult Purpose:To compare the D,D* and f value of healthy kidneys in different field strengths and investigate whether a IVIM-DWI conclusion is applicable to different field strengths.Research objects and methods 30 healthy volunteers,13 males and 17 females,aged 20-54 years,with an average age of(28.8 ± 9.01),mainly students and their families,were recruited to undergo kidney IVIM-DWI with the same sequence and parameters at different field intensity of 1.5T MR and 3.0T MR on the same day or within 24 hours,respectively,to compare the difference in the D,D*,and f value.Results:The D value of the left and right renal parenchyma of 3.0T MR was significantly greater than that of the 1.5T MR(P<0.05),D* value was less than 1.5T MR(P < 0.05).The f value had no difference between them(P > 0.05).Under the same field strength,1.5T MR left renal parenchyma D value > right kidney was statistically significant,while 3.0T MR the left and right renal parenchyma D value has no difference.The male and female D,D* and f value were not significantly different(P > 0.05)on 1.5T MR,while 3.0T MR male f value > female F value(P < 0.05).Conclusion:Under the condition of the same scanning parameters and different field intensities,the D and D* values of kidney ivim-dwi are statistically different,while the F values are not statistically different,so the stability of kidney ivim-dwi is high.Under the same scanning parameters,the difference of D value,D* value and F value between 1.5T MR and 3.0T MR was not synchronous.3.0T MR renal IVIM results(no difference between left and right kidneys,male perfusion score is higher than female),which is more in line with human physiology.The quantitative standard of ivim-dwi of kidney is affected by the field strength.Its reliability and feasibility need to be based on the same field strength and parameters.Part ?.Diagnostic efficiency of IVIM-DWI in staging of type 2 diabetic nephropathyPurpose: Analyze the IVIM-DWI parameters of renal in diabetic nephropathy(DN)different periods,and evaluate the correlation with glomerular filtration rate(e GFR),urinary albumin excretion rate(UAER)and creatinine,To investigate the differential diagnostic efficacy of IVIM-DWI for early DN and early and late DN.Research objects and methods: 52 patients who diagnosed with type 2 diabetes in the endocrine Department of The First Affiliated Hospital of Guangzhou Medical University from 2016 to 2018 were recruited,27 males and 25 females,with an average age of 54.58±7.64 years and 30 healthy volunteers,13 males and 17 females,aged 20-54 years,with an average age of(28.8 ± 9.01).Glomerular filtration rate(e GFR)was calculated by Simplified MDRD equation and combine with UAER to diabetic nephropathy(DN)staging,19 cases in?stage,8 cases in ? stage,14 in III phase,11 in IV stage,The double kidney axis(11 b values)IVIM-DWI scan was performed by PHILPS 3.0T MR,to measure the values of D,D* and f in renal cortex,compared the differences of IVIM-DWI corresponding parameters in different stages of kidney disease,and explore the correlation with glomerular filtration rate,UAER and creatinine.Results: The value of IVIM-DWI D can sensitively reflect the decrease of renal water molecular diffusion in early diabetic nephropathy,and has high accuracy in the early diagnosis of DN(I + II)and stage III.D,D* and f value have higher diagnostic efficiency for the development of ? phase to IV(AUC > 0.779).D,f value and UAER have moderate linear relationship(r=-0.558~-0.559),and have a linear relationship with creatinine,but the correlation is weak(r=-0.337~-0.449),and only the D value has moderate correlation with e GFR(r=0.513).Conclusion: 1.IVIM-DWI parameters of diabetic nephropathy cortex have a certain linear relationship with EGFR,UAER and creatinine respectively,but they are not synchronous,and they are moderately or weakly related.The change of D value is most closely related to the change of laboratory indexes.2.In the early stage of DN(I + II)to stage III,D value is highly sensitive and highly specific to monitor the change of renal function;while in the stage III to clinical stage IV of diabetic nephropathy,D,D * and F values have relatively high diagnostic specificity.3.IVIM-DWI can play a role of monitoring and early warning in the course of diabetic nephropathy.Combined with the comprehensive evaluation of the three parameters of D,D *,F,we can determine the best cutoff value.Ivim-dwi can play a good role in monitoring the course of diabetic nephropathy. |
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