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肾脏病与透析肾移植杂志 ›› 2025, Vol. 34 ›› Issue (5): 415-420.DOI: 10.3969/j.issn.1006⁃298X.2025.05.003

• 论著 • 上一篇    下一篇

功能磁共振体素内不相干运动序列参数与肾病综合征患者肾组织水肿的研究

  

  • 出版日期:2025-10-28 发布日期:2025-10-30

Intravoxel incoherent motion sequence for characterization of kidney interstitial edema due to nephrotic syndrome

  • Online:2025-10-28 Published:2025-10-30

摘要: 目的:探索功能磁共振体素内不相干运动(IVIM)序列对肾病综合征(NS)患者肾组织水肿的映射识别能力。方法:回顾性研究 2015 年 6 月至 2024 年 12 月国家肾脏疾病临床医学研究中心的 35 例 NS 患者(原发病包括微小病变肾病、局灶节段性肾小球硬化、膜性肾病),选取 25 例非 NS 表现的 IgA 肾病患者作为对照组。所有患者完成 24h 尿蛋白定量、血生化、肾功能、肾脏 B 超、肾活检病理及肾脏磁共振检查,收集 IVIM 序列数据(标准表观弥散系数 sADC、纯水分子扩散系数 D、伪扩散系数 D*、灌注分数 f),分析两组临床、病理及影像学指标差异。结果:两组肾功能无差异;NS 组左肾长径增大、肾组织水肿程度升高(P<0.001);NS 组肾脏皮质、髓质 sADC 值显著高于对照组(P 分别为 0.013、0.018),皮质、髓质 D值明显低于对照组(P 分别为 0.021、0.011);两组 D、f 值无统计学差异。结论:NS 患者肾组织 IVIM⁃sADC 值显著升高,D值显著降低,该类序列参数有望表征 NS 患者肾实质水肿程度。

关键词: 肾病综合征, 体素内不相干运动, 肾间质水肿

Abstract: Objective: To explore the mapping and recognition ability of the intravoxel incoherent motion (IVIM) sequence for renal edema in patients with nephrotic syndrome (NS). Methodology: A retrospective study was conducted on 35 patients with NS (including minimal change nephropathy, focal segmental glomerulosclerosis, membranous nephropathy) and 25 patients with IgA nephropathy (without NS) as the control group from June 2015 to December 2024. All patients completed 24⁃hour urine protein quantification, blood biochemistry, renal function, renal B⁃ultrasound, renal biopsy pathology, and renal magnetic resonance imaging. IVIM sequence data (including standard apparent diffusion coefficient sADC, pure water diffusion coefficient D, pseudo⁃diffusion coefficient D*, perfusion fraction f) were collected. Differences in clinical, pathological, and imaging indexes were analyzed. Results: There was no difference in renal function between the two groups. Compared with the control group, the left renal length and degree of renal edema increased in the NS group (P<0.001). The sADC values of renal cortex and medulla in the NS group were significantly higher (P=0.013, P=0.018), and the D* values were significantly lower (P=0.021, P=0.011) than those in the control group. There was no significant difference in D and f values. Conclusion: The IVIM sADC value of renal tissue in NS patients was significantly increased, and the D* value was significantly decreased, showing promise for characterizing the degree of renal parenchymal edema in NS patients.


Key words: nephrotic syndrome, intravoxel incoherent motion, renal interstitial edema