Significance Of Magnetic Resonance Diffusion-weighted Imaging Detection In Evaluating Renal Fibrosis

Objective:Magnetic resonance diffusion-weighted imaging（DWI）can reflect the physiological characteristics and pathological changes of tissues from the perspective of water molecule diffusion.In this study,a 3.0T magnetic resonance machine was used to investigate the significance of DWI detection in clinical evaluation of renal fibrosis.Method:52 patients（48 eventually included）with CKD who were admitted to the Department of Nephrology of Qingdao Municipal Hospital from January to October of2018 were selected as the test group.CKD staging was performed according to the definition of chronic kidney disease in the K/DOQI guidelines:CKD3-5.In addition,24healthy subjects in the same period of the hospital were used as the control group.The selected subjects were subjected to MR routine examination and DWI examination,and DWI used single-shot plane echo（SS-EPI）sequence.The DWI image was processed by the MR READY View software of the GE AW 4.6 workstation to obtain the apparent diffusion coefficient（ADC）value of the kidney;Single kidney glomerular filtration rate（SKGFR）was measured in the text group using ^99mTc-DTPA renal dynamic imaging,simultaneously detecting serum creatinine（SCr）,blood urea nitrogen（BUN）,serum cystatin C（CysC）,serumβ2-microglobulin（β2-MG）and obtaining the length of the kidney through renal B-ultrasound;In addition,19 patients with CKD underwent percutaneous renal biopsy and obtained renal pathological damage scores through the Katafuchi semi-quantitative scoring system.All data were statistically analyzed using SPSS 19.0 software.All quantitative data were tested for normal distribution and the results were described by mean±standard deviation.Independent sample t test was used to compare the ADC values of the left and right kidneys of the selected subjects.One-way analysis of variance was used to compare the renal ADC values between the control group and the text group;The correlations between renal ADC values in the text group and quantitative data such as SKGFR,SCr,and renal pathological damage scores were used Pearson correlation analysis.The inspection level is set to 0.05 unless otherwise stated.Result:1.There was no significant difference in ADC values between the left and right kidneys of the control group and the text group（P>0.05）.2.When the diffusion sensitive gradient factor（b value）is 800s/mm²,the renal ADC values(×10^-3mm2/s)of the control group,chronic kidney disease stage 3,stage 4,and stage 5 were（2.18±0.04）,（2.05±0.05）,（1.94±0.10）and（1.82±0.09）respectively.One-way analysis of variance showed that there was a statistically significant difference between the renal ADC values of the control group and the renal ADC values of the text group（P<0.05）,further analysis of the ADC values of each group of kidneys showed that the ADC values of any two groups were statistically significant（P<0.05）.3.The single renal ADC value of the test group was positively correlated with SKGFR（r=0.70,P<0.05）,and had no correlation with kidney size（long diameter）（r=0.04,P>0.05）.4.The ADC values of the test group were negatively correlated with SCr（r=-0.68,P<0.05）,BUN（r=-0.66,P<0.05）,serum CysC（r=-0.78,P<0.05）and serumβ2-MG（r=-0.69,P<0.05）.5.The renal ADC value of the renal biopsy was negatively correlated with the renal pathological damage score（r=-0.58,P<0.05）.Conclusion:Renal fibrosis can be assessed to some extent by the apparent diffusion coefficient（ADC）of the kidney,The development and maturity of magnetic resonance diffusion-weighted imaging（DWI）technology is expected to play an important clinical value in the diagnosis,degree determination and clinical diagnosis and treatment of renal fibrosis.