| Objective:To explore the application of magnetic resonance Diffusion-Weighted MR imaging(DWI)in the evaluation of chronic kidney disease renal function;and to determine the relationship between the apparent diffusion coefficient ADC)and kidney filtration function.Materials and Methods:76 cases part of the healthy volunteers and patients with chronic kidney disease of The Affiliated Hospital of Luzhou Medical College from February 2011 to October 2011 were Collected in this study.All patients underwent conventional magnetic resonance imaging,breath hold diffusion-weighted imaging and breathe freely diffusion-weighted imaging.some of whom were excluded because of no result or the quantity of the imaging was bad.60 persons were included finally,in which there were 18 volunteers as control group and 42 patients with chronic kidney disease(CKD)were underwent DW MR imaging in a dehydrated state.In CKD group,14 cases were with normal SCr level(CKD group 1)and 18 cases with SCr increased in different level(CKD group 2).The motion probing gradienter(b gradient)were applied along 6 different directions and four b-values(0,50,100 and 400s/mm2)were selected for isotropic parameter in each direction.By comparing different b values,The signal-to-noise ratio(SNR),contrast to noise ratio(CNR),and ADC values were calculated to evaluate the difference image quality on breath-hold DWI and free breathing DWI.Apparent Diffusion Coefficient(ADC)value in all cases of different b values was measured and compared of their relationships with The mean serum creatinine(SCr),creatinine clearance(CCr),blood urea nitrogen(BUN),glomerular filtration rate(GFR).Results:60 cases of free-breathing DWI image SNR is lower than the breath scan SNR and the difference has no statistical significance(P>0.05).60 cases of free-breathing DWI image CNR is lower than the breath scan CNR and the difference has no statistical significance(P>0.05).Free breathing scanning with breath scan,the ADC value was no significant difference(P>0.05).The SNR of different b values have significant statistical significance(P<0.01);the SNR with b value of 50s/mm2 is the largest.The CNR of different b values have statistical significance(P<0.01);the CNR with b value of 50 s/mm2 is the largest.The ADC values in the normal control group in different b values(50?100?400s/mm2)were(385.366± 15.914)× 10-5mm2/s?(341.639±23.159)× 10-5,mm2/s,and(247.192± 13.076)× 1 0-5mm2/s,respectively.The ADC values of CKD group 1 were(306.192± 12.370)×10-5mm2/s?(288.142±21.368)×10-5mm2/s,And(204.398±14.374)×10-5mm2/s.And of CKD group 2 were(278.717±64.930)×10-5mm2/s?(235.405±59.751)×10-5mm2/s,and(181.672±26.494)×10-5mm2/s,respectively.The ADC values in CKD group were lower than those of the normal kidneys(t values compared between the control group and CKD group 1 were 8.625?5.197?9.193 separately,between the control group and CKD goup 2 were 6.573,7.182,10.964 separately in different b values,P<0.05).In CKD group 2,(it had been showed negtive correlation between the level of SCr and ADC values of kidney.with mean level of SCr of(718.490±609.350)umol/L,but this was confirmed of no statistical meanings(the coefficient correlation were-0.172,-0.293,-0.043,separately in different b values(50,100,400 s/mm2),(P>0.05).In CKD group 2,(it had been showed negtive correlation between the level of BUN and ADC values of kidney.with mean level of BUN of(7.324±4.541)mmol/L,(the coefficient correlation were-0.709,-0.614,-0.539 separately,in different b values(50 100 400 s/mm2),(P>0.05).In CKD group 2,(it had been showed positive correlation between the level of CCr and ADC values of kidney,with mean level of CCr of(16.415±13.841)ml/min,(the coefficient correlation were 0.561,0.428,0.375 separately,in different b values(50,100,400s/mm2),(P<0.05).In CKD group 2,(it had been showed positive correlation between the level of CGFR and ADC values of kidney.with mean level of GFR of(21.108±7.601)ml/min,(the coefficient correlation were0.615,0.573,0.479 separately,in different b values(50,100,400 s/mm2),(P<0.05).Conclusion MR diffusion-weighted imaging and ADC value of measuring have a certain feasibility in renal function evaluation of chronic kidney disease.It can be quantitatively reflect the renal function of chronic kidney disease status,it is a non-invasive renal function evaluation method. |
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