Experimental And Clinical Research On Chronic Nephritis, And Renal Space-occupying Diseases Of DTI

Purpose:To evaluate the influence on image quality from b value, age, gender, location of normal kidney. For patients with chronic glomerulonephritis and renal space-occupying lesions, DTI focus on early renal damage identification, kidney stage assessment, identification of benign and malignant lesions, relation between its value and pathological changes.Materials and methods:60healthy volunteers were randomly selected using a1.5TMRI. Ss-EPI were adopted, TR1400ms, TE82ms, half Fourier acquisition6/8, with a layer gap0, layer number10, diffusion gradient direction is6, with respiratory triggering mode, five groups b value ie.(0,200,400,600,800,1000) s/mm2, and the ADC,FA value, SNR, CNR were compared.For75patients with chronic glomerulonephritis, the relation between ADC, FA values and renal function, area of glomerular sclerosis, renal interstitial fiber area were analyzed.70renal space-occupying lesions using three groups of b value (0,400),(0,600),(0,800) s/mm2were evaluated. Renal benign and malignant lesions, including cystic and solid components, were analyzed.The ADC, FA values and El and the correlation between measurement parameters and cell density, microvascular density were evaluated.Results:For volunteers, renal parenchyma, cortex and medulla ADC values, SNR is statistically significant in different group (P<0.05); FA value, CNR is not statistically significant (P>0.05). b value (0,800) s/mm2meet the diagnostic requirements.The correlation between renal parenchyma and renal cortex, medullary ADC, FA values were found (P<0.01); The measurements between different gender, age and position of kidney are not statistically significant (P>0.05). ADC, FA value of CGN patients decreases with decline in renal function, the differences were found (P<0.05). The area under the ROC curve of ADC value and FA value distinguishing CKD stage1and2-5chronic kidney disease were0.979,0.946(P<0.05). Renal cortex, medullary FA, ADC values and glomerular sclerosis area have the higher negative correlations (P<0.05). Renal medulla and cortex FA, ADC value and renal interstitial fibrosis area has the higher negative correlations (P<0.05); For renal lesions occupied, ADC, El value decreases with the increase of b value, the FA value has no obvious change. When b value is (0,800) s/mm2,the E1values for identifying solid ingredients was the highest,the area under the ROC curve is0.923, the best diagnostic threshold of1.61×10-3mm2/s. By conctast, the area under the ROC curve of ADC values identifing cystic part was0.932, the best diagnostic threshold of2.76×10-3mm2/s. For renal clear cell carcinoma, the difference between different levels of cell density, microvascular density were found (t=4.50,4.03, P<0.05). The correlation between the ADC, E1, FA value and cell density, the microvascular density were found (P<0.05).Conclusion:DTI can be used in normal kidney, the CGN and renal lesions differential diagnosis, shows a good prospect of clinical application. The concrete conclusion is as follows. When b=0,600s/mm2, the image quality was better. Age, sex and position of kidney have no effect on measurement.The ADC and FA values can be used for the early recognition of the kidney damage and used to evaluate the pathological change. ADC, E1, FA values can be used in the identification of benign and malignancy placeholder and assess cell density and microvascular density.