摘要
目的探讨血氧水平依赖(BOLD)联合mDixon Quant定量评估2型糖尿病(T2DM)患者早期肾脏氧代谢和铁沉积的效果。方法前瞻性收集2022年9月—2023年12月天津市第一中心医院58例T2DM患者资料,根据尿白蛋白/肌酐比值(ACR)分成正常白蛋白尿(NAU,ACR<30 mg/g)组35例和微量白蛋白尿(MAU,30 mg/g≤ACR<300 mg/g)组23例。同期纳入33例健康志愿者作为对照组。所有受试者行腹部BOLD及mDixon Quant序列扫描,测量肾皮质、髓质表观弛豫率(R2^(*))。比较各组间一般资料及影像学参数值的差异,应用受试者工作特征(ROC)曲线分析相关参数对早期肾功能改变的诊断效能。结果对照组、NAU组和MAU组体质量、估算的肾小球滤过率(eGFR)、ACR差异有统计学意义(P<0.01)。同组内肾皮质R2^(*)值均低于肾髓质R2^(*)值(P<0.01)。3组间除BOLD肾皮质R2^(*)值差异无统计学意义外,其余参数差异均有统计学意义(P<0.05)。区分对照组与NAU组、NAU组与MAU组、对照组与T2DM早期(NAU+MAU)时,两序列联合的曲线下面积(AUC)均高于任何单一序列,其AUC值分别为0.892(95%CI:0.809~0.975)、0.785(95%CI:0.666~0.904)和0.841(95%CI:0.756~0.926)。结论BOLD联合mDixon Quant能够无创、定量评估T2DM患者早期肾脏氧代谢及铁含量变化情况,两序列联合的诊断效能更优。
Objective To assess renal oxygen metabolism and iron deposition in type 2 diabetes mellitus(T2DM)patients using a combination of blood oxygen level-dependent(BOLD)and mDixon Quant techniques.Methods Clinical data of 58 T2DM patients from Tianjin First Central Hospital(September 2022-December 2023)were prospectively collected.According to urinary albumin-to-creation ratio(ACR),patients were divided into the normal albuminuria(NAU,ACR<30 mg/g,n=35)group and the microalbuminuria(MAU,30 mg/g≤ACR<300 mg/g,n=23)group.Thirty-three healthy volunteers were included as the control group during the same period.All participants underwent renal BOLD and mDixon Quant MRI to obtain cortical and medullary apparent relaxation rate(R2^(*))values.The differences of general data and image parameter values were compared between groups.Receiver operating characteristic(ROC)curves were used to analyze the diagnostic efficacy of relevant parameters for early renal function changes.Results There were significant differences in body weight,estimated glomerular filtration rate(eGFR)and ACR between the control group,the NAU group and the MAU group(P<0.01).The R2^(*)value in renal cortex was lower than that in renal medulla(P<0.01)in the same group.Apart from R2^(*)value of BOLD renal cortex,which showed no significant difference between the three groups(P<0.05),and the differences in the other parameters were statistically significant(P<0.05).When distinguishing between the control group and the NAU group,the NAU group and the MAU group,as well as between the control group and the early-stage T2DM(NAU+MAU)group,the combined two-sequence approach demonstrated higher area under the curve(AUCs)than any single sequence alone,with AUC value of 0.892(95%CI:0.809-0.975),0.785(95%CI:0.666-0.904)and 0.841(95%CI:0.756-0.926),respectively.Conclusion The combination of BOLD imaging with mDixon Quant enables noninvasive and quantitative assessment of alterations in renal oxygen metabolism and iron content in early-stage T2DM patients.The diagnostic performance of this combined approach surpasses that of individual methods.
作者
任宇
李慧宇
马亚杰
张钰玲
季倩
REN Yu;LI Huiyu;MA Yajie;ZHANG Yuling;JI Qian(The Medical Technology School,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;First Central Hospital of Tianjin Medical University;Department of Radiology,Jiangsu Provincial Northern Jiangsu People's Hospital;Department of Radiology,Tianjin First Central Hospital,Tianjin Institute of Imaging Medicine)
出处
《天津医药》
2025年第11期1197-1203,共7页
Tianjin Medical Journal
基金
天津市医学重点学科(专科)建设项目(TJYXZDXK-041A)
天津市自然科学基金(21JCYBJC01050)。
关键词
糖尿病
2型
白蛋白尿
血氧水平依赖
mDixon
Quant
肾功能
氧代谢
铁沉积
diabetes mellitus,type 2
albuminuria
blood oxygenation level dependent
mDixon Quant
renal oxygenation
oxygen metabolism
iron deposition
