Use FMRI To Evaluate Renal Function After Partial Nephrectomy Of Renal Cell Carnonima

Objective: Using arterial spin labeling?ASL?and intravoxel incoherent motion?IVIM?MR imaging to evaluate the residual renal function in patients with renal cell carcinoma after laparoscopic partial nephrectomy.Subjects and methods: 30 patients with renal tumor who underwent laparoscopic partial nephrectomy and 30 age-matched healthy volunteers were enrolled in this study.The patients did renal scintigraphy 99 m Tc-DTPA preoperative assessment of the contralateral kidney preoperative glomerular filtration rate?GFR?.And after renal scintigraphy in 72 hours,3 months,6 months and 12 months,We also did the ASL and IVIM scan,through postprocessing renal blood flow?RBF?,pseudo-diffusion coefficient(ADC_fast)and perfusion fraction?PF?in the cortex and medullar were measured.Statistical analysis was performed using SPSS 19 statistical software,measurement data expressed by x±s.The renal cortex and medullary RBF values of ADC_fast,PF value for the normal distribution test,confirmed the data meet the normal distribution,taking the intraclass correlation coefficient?ICC?analysis of 2 medical division test the consistency of each index weight value of the renal cortex and medulla,ICC?0.75 means good consistency,0.40?ICC<0.75 means medium consistency,ICC<0.40 means poor consistency.Independent sample t test to compare the group of healthy volunteers with bilateral renal cortex,medulla and the difference between cortex and medulla between each index value,and take the group of healthy volunteers left renal values for further analysis;Pearson correlation coefficients were used to evaluate the correlation of index values with GFR,as well as the correlation of cortical ADC_fast,PF and RBF;Use independent sample t test to compare healthy volunteers,patients affected side before operation and contralateral side renal ADC_fast,PF value difference;take repeated measurements analysis of variance the difference of each index at each time point value of the renal cortex and medulla;Use independent sample t test to compare each parameter 12 months after surgery of patients and healthy volunteers.According to the difference of the indexes of renal medulla,the difference of p<0.05 was statistically significant.Results:?1?All index values showed good reproducibility between doctors with an ICC larger than 0.75;?2?There was a positive correlation between RBF,ADC_fast and PF value of the contralateral renal cortex and GFR?R value was 0.560,0.532,0.678,p<0.01?;?3?There was a positive correlation between ADC_fast and PF value of the contralateral kidney medulla and GFR?R value was 0.622,0.601,p<0.01?;?4?There was a positive correlation between ADC_fast and PF value of the contralateral kidney medulla and RBF?R value was 0.537,0.598,p<0.01?;?5?There was no significant difference in RBF,ADC_fast and PF between the renal cortex and the renal medulla in healthy volunteers?p>0.05?;?6?The RBF,ADC_fast,and PF values of renal cortex in healthy volunteers were significantly higher than those in medulla,the difference was statistically significant?p<0.05?;?7?There was significant difference in ADC_fast and PF values between the affected and contralateral renal medulla?p<0.05?;?8?3 months after surgery renal residual cortex RBF,Cortical and medullary ADC_fast,PF value is higher than that before operation?p<0.05?;6 months after surgery with parameters of remnant renal tissue side higher than the 3 months?p<0.05?,12 months earlier had no change;?9?At 3 months after operation,the renal cortex RBF,ADC_fast,PF were decreased compared with preoperative?p<0.05?,and the parameters of the residual renal tissue were decreased in the latter group?p<0.05?after operation;?10?There was no significant difference in RBF,ADC_fast,and PF?p<0.05?of the renal cortex and medulla of the affected side and the healthy side in 12 months after operation.Conclusion: ASL and IVIM can be used to evaluate renal function,and it is valuable to evaluate the renal perfusion function after laparoscopic partial nephrectomy.