目的：探讨Ⅰ~Ⅱ期糖尿病肾病大鼠模型磁共振张量成像（DTI）表现及变化规律。材料与方法：20只SD雄性大鼠，按随机数字表法将大鼠分为2组，实验组14只，实际存活9只，共18个肾脏，对照组6只，共12个肾脏；实验组给予1%链脲佐菌素腹腔注射造模，对照组给予同等剂量的柠檬酸缓冲液（pH 4.5）；2周后对两组大鼠行常规MRI检查及DTI检查，在6个非共线方向上施加扩散敏感梯度场，b值取0、600 s/mm2；并留取血尿标本测量尿微量白蛋白、血肌酐；取双肾行病理检查；由两名经验丰富的放射科医师盲法观察及测量双侧肾脏皮质、髓质兴趣区的ADC值和FA值。结果：实验组大鼠血糖明显升高，两组血肌酐、尿微量白蛋白均正常；实验组动物大鼠双肾病理表现为Ⅰ~Ⅱ期DN损害，对照组大鼠双肾病理均正常；实验组大鼠皮、髓质ADC值较对照组增大，差异有统计学意义（P<0.05）；实验组皮、髓质FA值比较，差异有统计学意义（P<0.05）；实验组皮、髓质FA值与对照组皮、髓质FA值比较，差异无统计学意义（P>0.05）。结论：DTI成像的ADC值和FA值能够在一定程度上，较血尿生化指标更能反映早期DN的病理改变。
Abstract
Objective: To prospectively assess the manifestation of stage Ⅰ and Ⅱ diabetic nephropathy rats using diffusion tensor imaging(DTI) MRI at 3.0T. Materials and Methods: Twenty male SD rats were randomly divided into 2 groups according to the random number table. Fourteen rats were in the experimental group, the final survival of 9 rats with 18 kidneys, and 6 rats were in the control group with 12 kidneys. The experimental group was treated with 1% streptozotocin, and the control group was given the same dose of citrate buffer solution. Two weeks later, both of the two groups of rats underwent conventional MRI and DTI examination with b value of 0 and 600 s/mm2(diffusion directions=6), and the serum creatinine and microalbuminuria were measured and the pathological change of all kidneys were examined. Mean apparent diffusion coefficient(ADC) and fractional anisotropy(FA) were determined for the cortex and the medulla by two experienced radiologists blinded. Results: The blood glucose of experimental group was significantly increased, and the serum creatinine and microalbuminuria in both of the two groups of rats were normal. The pathological changes of the kidneys in the experimental group were stage Ⅰ and Ⅱ diabetic nephropathy expression, and the control group was normal. The ADC values of cortex and medulla were increased in the experimental group compared with the control group and the difference was statistically significant(P<0.05). In the experimental group, the difference of FA values were statistically significant between cortex and medulla(P<0.05). While there were no significant differences in the FA values of the cortex and medulla between two groups(P>0.05). Conclusion: The ADC value and FA value of DTI imaging maybe be more able to reflect the pathological changes than the biochemical indicator in the early stage of diabetic nephropathy.
关键词
糖尿病肾病 /
磁共振成像
Key words
Diabetic nephropathies /
Magnetic resonance imaging
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1]Cakmak P, Yagci AB, Dursun B, et al. Renal diffusion-weighted imaging in diabetic nephropathy: correlation with clinical stages of disease[J]. Dir, 2014, 20(5): 374-378.
[2]Li X, Xu X, Zhang Q, et al. Diffusion weighted imaging and blood oxygen level-dependent MR imaging of kidneys in patients with lupus nephritis[J]. J Trans Med, 2014, 12(1): 295-301.
[3]Sivrioglu AK, Mehmet A, Kara K, et al. Diffusion-weighted MRI in assessment of renal dysfunction[J]. Ind J Radiol Imaging, 2012, 22(3): 155-159.
[4]Masarapu V, Kim HL. Initial experience with arterial spin-labeling MR imaging to assess histology of renal masses[J]. Quant Imaging Med Surg, 2013, 3(3): 130-131.
[5]Zhang JL, Morrell G, Rusinek H, et al. New magnetic resonance imaging methods in nephrology[J]. Kid Int, 2014, 85(4): 768-778.
[6]Chuck NC, Steidle G, Blume I, et al. Diffusion tensor imaging of the kidneys: influence of b-value and number of encoding directions on image quality and diffusion tensor parameters[J]. J Clin Imaging Sci, 2013, 3(4): 53.
[7]Lu L, Sedor JR, Gulani V, et al. Use of diffusion tensor MRI to identify early changes in diabetic nephropathy[J]. Am J Nephrol, 2011, 34(5): 476-482.
[8]李晓玲，朱旅云，宋光耀，等. 脐带间充质干细胞移植对1型糖尿病大鼠模型血糖及肾脏不能改变的影像研究[J]. 解放军医药杂志，2013，25（7）：31-34.
[9]田佳星，赵静波，李敏，等. 糖胃安方对链脲佐菌素诱导的1型糖尿病大鼠小肠生物力学重构的影响[J]. 中国糖尿病杂志，2015，23（7）：637-643.
[10]Tervaert TW, Mooyaart AL, Amann K, et al. Pathologic classification of diabetic nephropathy[J]. JASN, 2010, 21(4): 556-563.
[11]Morani AC, Elsayes KM, Liu PS, et al. Abdominal applications of diffusion-weighted magnetic resonance imaging: where do we stand?[J]. WJR, 2013, 5(3): 68-80.
[12]Xu X, Fang W, Ling H, et al. Diffusion-weighted MR imaging of kidneys in patients with chronic kidney disease: initial study[J]. Eur Radiol, 2010, 20(4): 978-983.
[13]Hueper K, Hartung D, Gutberlet M, et al. Magnetic resonance diffusion tensor imaging for evaluation of histopathological changes in a rat model of diabetic nephropathy[J]. Invest Radiol, 2012, 47(7): 430-437.
[14]Xu Y, Wang X, Jiang X. Relationship between the renal apparent diffusion co-efficient and glomerular filtration rate: preliminary experience[J]. J Magn Reson Imaging, 2007, 26(3): 678-681.
[15]Ries M, Basseau F, Tyndal B, et al. Renal diffusion and BOLD MRI in experimental diabetic nephropathy. Blood oxygen level-dependent[J]. J Magn Reson Imaging, 2003, 17(1): 104-113.
[16]叶靖,吴晶涛，张萍. 磁共振扩散张量成像对新西兰白兔糖尿病肾病诊断价值的初步研究[J]. 中国现代医学杂志，2012，22（16）：37-39.
基金
四川省教育厅自然科学重点项目（编号：132A0285）
