Value Of Magnrtic Resonance Diffusion Tensor Imaging In Children With Acute Kidney Injury

Objective:To explore the application value of magnetic resonance diffusion tensor imaging(DTI)quantitative assessment of early renal function(AKI)in early renal function and clinical staging.Materials and methods:From November 2017 to October 2019,47 children with AKI standard were collected from Hunan children’s Hospital,and 23 children volunteers were included in the control group.Perform MR routine scan and DTI scan on all the test children,import the DTI sequence into Siemens Neuro 3D workstation,measure the fractional anisotropy(FA)and average diffusion coefficient(ADC)values of double renal cortex medulla in all test children,and perform DTT treatment on them,and collect AKI children for 24 h Internal serum creatinine value.The FA and ADC values of left and right renal cortex and medulla were compared in groups,and the FA and ADC values of their own cortex and medulla were compared by paired t-test;Independent sample t test was used to compare the ADC value and FA value of the two groups of children;Correlation analysis of ADC value and FA value of renal cortex,medulla and serum creatinine in children with AKI;One-Way ANOVA analysis of variance and pairwise comparison between the FA and ADC values of dermal medulla in the control group and children with AKI.P <0.05 statistically significant.Result:1.There were no significant differences in the age,BMI,and sex composition ratio between the experimental group and the control group(P >0.05).2.There was no significant difference between the experimental group and the control group in their left renal cortex medulla FA and ADC values and right renal cortex medulla FA and ADC values(P > 0.05).3.Compared with the control group,the FA value of bilateral renal medulla is greater than the FA value of cortex,with statistical difference(P <0.001).The ADC value of medulla in the control group was smaller than that of the cortex,and the ADC value of medulla in the experimental group was greater than that of the cortex.The difference was statistically different.(P <0.05).4.The medullary FA,cortical FA,and ADC values in the experimental group were significantly lower than those in the control group,and the differences were statistically significant(P <0.001).There was no significant difference in the ADC value of the medulla between children with AKI and the control group(P >0.05).5.There was a statistically significant difference in the renal medulla FA value between the AKI subgroup and the normal control group(P <0.001);The ADC value of renal cortex in children was not statistically different between AKI stage one and stage two(P >0.05),and there were statistical differences in the other stages(P <0.001);The differences in renal cortical FA values between the AKI subgroup and the normal control group were statistically significant(P <0.001),and there were no statistical differences between the different staging groups(P >0.05).There were no significant differences between the renal medullary ADC stages and the control group(P =0.463).6.In children with AKI,the medulla FA value and cortical ADC value were negatively correlated with the serum creatinine value(r =-0.868,r =-0.436,P <0.001),and the other cortical FA values and ADC value were not related to serum creatinine(P =0.607,P =0.082).7.Fibrous bundle tracing imaging can show the tubular microstructure of the renal medulla,showing a dominant direction of diffusion.The tubular structure of renal medullary fibers in children with AKI stage one,two,and three showed varying degrees of reduction,disorder,and premature interruption.Represents varying degrees of diffusion limitation,suggesting pathological changes in the the kidney.Conclusion: As a non-invasive magnetic resonance functional imaging method,DTI can reflect the early renal function impairment of AKI.The reduction of its quantitative parameters FA and ADC values can effectively reflect the changes of renal injury function.Its renal medulla FA value is useful for early assessment of renal function More sensitive,can evaluate changes in renal function in different stages of acute kidney injury,Fiber tensor tractography(DTT)technology indirectly reflects the renal medullary ductal structure in children,and has potential application value for clinical diagnosis and early evaluation of AKI.