In vivo evaluation of renal function using diffusion weighted imaging and diffusion tensor imaging in type 2 diabetics with normoalbuminuria versus microalbuminuria
In vivo evaluation of renal function using diffusion weighted imaging and diffusion tensor imaging in type 2 diabetics with normoalbuminuria versus microalbuminuria
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DOI：
10.1007/s11684-014-0365-8
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发表时间：
2014-12-01
影响因子：
8.1
通讯作者：
Tan, Yuyu
中科院分区：
文献类型：
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作者：
Chen, Xiaoyan;Xiao, Wenxia;Tan, Yuyu
本研究旨在前瞻性评价弥散加权成像(DWI)和弥散张量成像(DTI)对正常白蛋白尿(NAU)和微量白蛋白尿(MAU)的2型糖尿病患者早期肾损害的诊断价值。选择30例肾功能正常的2型糖尿病患者，根据8h尿白蛋白排泄率(AER)结果分为NAU组(n=14)和MAU组(n=16)。健康体检接受者的当代队列作为对照(n=12)。采用SE单次激发EPI对双侧肾脏进行DWI和DTI扫描，根据ADC图和FA图测定肾实质的表观扩散系数(ADC)和分数各向异性(FA)。比较三组的ADC值和FA值。根据弥散加权指数(b值为400 S/mm(2))，MAU组和NAU组的平均ADC值明显低于健康对照组(P<；0.01)。MAU组平均ADC值[(2.22+/-0.07)×10(-3)mm(2)/S]略低于NAU组[(2.31+/-0.22)×10(-3)mm(2)/S]，但差异无统计学意义(P>；0.05)。MAU组FA值高于对照组(0.45+/-0.07vs.0.39+/-0.03，P=0.004)，与NAU组(0.42+/-0.03)差异无统计学意义(P>0.05)。ADC值和FA值在反映早期肾损害方面可能比尿AER更敏感，有助于早期发现和定量评估T2 DM患者的肾损害。联合评估ADC值和FA值可能为早期诊断糖尿病肾病提供更好的定量方法。
This work aims to estimate the value of diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) in detecting early-stage kidney injury in type 2 diabetic patients with normoalbuminuria (NAU) versus microalbuminuria (MAU) prospectively. A total of 30 T2DM patients with normal kidney function were recruited and assigned to the NAU group (n = 14) or MAU group (n = 16) according to 8 h overnight urinary albuminuria excretion rate (AER) results. A contemporary cohort of health check-up recipients were included as controls (n = 12). DWI and DTI scans were performed on bilateral kidney using SE single-shot EPI, and apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of the renal parenchyma was determined from ADC and FA maps of the three groups. ADC and FA values were compared among the three groups. According to DWI with a b value of 400 s/mm(2), the MAU and NAU groups showed significantly lowered mean ADC values compared with the healthy controls (P < 0.01). The mean ADC in the MAU group [(2.22 +/- 0.07) x 10(-3) mm(2)/s] was slightly lower than that of the NAU group [(2.31 +/- 0.22) x 10(-3) mm(2)/s], but this difference was not statistically significant (P > 0.05). The FA value in the MAU group was higher than that in the control group (0.45 +/- 0.07 vs. 0.39 +/- 0.03, P = 0.004) but did not differ from that in the NAU group (0.42 +/- 0.03) (P > 0.05). ADC and FA values may be more sensitive than urine AER in reflecting early-stage kidney injury and, hence, may facilitate earlier detection and quantitative evaluation of kidney injury in T2DM patients. Combined evaluation of ADC and FA values may provide a better quantitative approach for identifying diabetic nephropathy at early disease stages.