ADC直方图分析在慢性肾脏病患者肾间质纤维化评估中的价值

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[Abstract]Objective：ToexplorethepotentialofhistogramanalysisbasedonrenalcortexADCinevaluatingrenalinterstitial fibrosisinchronickidneydisease（CKD）.Methods：5OpatientswithCKDwereretrospectivelyincludedanddivided intothe mildfibrosisgroup（27cases）andthemoderate-severefibrosisgroup（23cases）usingsemi-quantitativecriteria.Allpatients underwentDWI examinationbeforerenalbiopsy.ThehistogramparametersofADC mapswereobtainedby FireVoxel. Independent-sample -test was used to compare the ADC histogram parameters between the two groups.Spearmanrank correlation testwasusedtoanalyzethecorrelationbetween histogramparametersandfibrosisscore.ROCcurvewasusedto evaluatethediagnosticeficacyofthehistogramparametersanddeterminetheoptimalthreshold.Results：SixcortexADC histogramparameters（mean，Oth，25th，75th，90thpercentilesandentropy）weresignificantlydiferentbetweethetwo groups（all P <0.05）.The mean value of cortex ADC had the strongest correlation with serum creatinine and eGFR（ r= （204号 -0.536，0.440，both P⩽0.001 ）.The25th percentile of cortex ADC had the strongest correlation with the degree of fibrosis（ r= -0.572，P=0.001 ），with thelargestAUCof0.816（95%CI O.681-0.911）for differentiating themildandmoderate-severe fibrosis groups.The25thpercentileofcortexADCcombinedwitheGFRpresentedahigherdiferentialdiagnosticeficacy，withAUC of0.860（95%CI O.732-0.942）．Conclusion：CorticalADC basedhistogramanalysisis feasibleinnon-invasiveevaluationof fibrosis in patients with CKD.

[Keywords]Chronickidneydisease;Renalfibrosis;Magneticresonanceimaging;Apparentdifusioncoeffient;Histogramnalysis

慢性肾脏病（chronic kidney disease，CKD）是全球公认的公共卫生问题，若不及时诊断治疗，可发展成终末期肾病，给患者及社会带来沉重的经济负担[1-2]。（剩余6964字）