【摘要】 目的:探讨T₁-mapping定量分析技术评估肾移植术后早期肾功能的价值。方法:将76例异体肾移植术后2⁴周的患者及26例健康志愿者（对照组）纳入研究,根据肾小球滤过率（eGFR）将患者组分为3组:A组为移植肾功能良好组（n=44）;B组为移植肾功能轻中度受损组（n=19）;C组为移植肾功能重度受损组（n=13）。所有受试者均行常规序列和斜矢状面改良Look-Locker反转恢复（MOLLI）序列MRI检查,测量肾脏皮髓质的T1值。比较各组内及各组间肾脏皮髓质T1值的差异,分析移植肾皮质、髓质T1值与eGFR间的相关性,采用ROC曲线分析T1值对不同功能移植肾的鉴别诊断价值。结果:各组内肾皮质的T1值均明显小于肾髓质（P<0.001）。A、B、C和对照组中肾皮质的T1值分别为（1511.95±111.31）、（1663.22±66.81）、（1719.09±74.47）和（1748.88±62.72）ms,除B组与C组间的差异无统计学意义（P=0.05）外,其余各组间的差异均有统计学意义（P<0.05）。A组肾髓质的T1值[（2009.65±97.83）ms]大于对照组[（1946.91±51.43）ms],差异有统计学意义（P=0.004）,其余各组间肾髓质T1值的差异无统计学意义（P>0.05）。移植肾皮质的T1值与eGFR呈负相关（r=-0.45,P<0.01）。肾皮质T1值鉴别移植肾功能良好与移植肾功能受损（包括轻中度与重度受损）时曲线下面积（AUC）为0.75,诊断灵敏度及特异度分别为88.6%及83.1%。结论:T1-mapping定量分析技术对评估肾移植术后早期肾功能具有一定价值,有望成为临床上无创监测移植肾功能的方法。更多还原

【Abstract】 Objective:To explore the value of T₁ mapping to quantitative analyze the difference of T₁-values in different renal allografts function early after kidney transplantation.Methods:In this prospective study,76 renal allograft recipients 2 to 4 weeks after kidney transplantation and 26 age-matched volunteers were included.Recipients were divided into three groups according to the estimated glomerular filtration rate（eGFR）:group A（n=44）,recipients with good allograft function(eGFR≥60 mL/（min·1.73 m2）;group B（n=19）,recipients with mild to moderate impaired allograft function(30≤eGFR<60 mL/（min·1.73 m2）;group C（n=13）,recipients with severe impaired allograft function [eGFR<30 mL/（min·1.73 m2）].At the same time,healthy volunteers（n=26）were selected as the control group.All subjects underwent conventional MRI and modified Look-Locker inversion recovery sequence（MOLLI）MRI which was performed in the oblique-sagittal plane.Renal cortical and medullary T₁-values were measured.Difference of cortical and medullary T₁-values within the group or among four groups were compared.Correlation of cortical and medullary T₁-values with eGFR was evaluated.The diagnostic efficacy of using T₁-mapping to discriminate different renal function was assessed.Results:The cortical T₁-values were significantly lower than the medullar T₁-values in each group（P<0.001 for all）.Cortical T₁-value was（1511.95±111.31）,（1663.22±66.81）,（1719.09±74.47）and（1748.88±62.72）ms for four groups respectively,it was significantly different between each other except group B and C（P<0.05）.Medullary T₁-value was（2009.65±97.83）ms in group A,they were larger than that in control group which was（1946.91±51.43）ms（P=0.004）.There was no statistically significant difference in medullary T₁-values between other groups（P>0.05）.Cortical T₁-values exhibited a negative correlation with renal function as determined by eGFR for recipients（r=-0.45,P<0.01）.Mean cortical T₁ values showed a high area under the ROC curve（AUC=0.75）to discriminate renal allografts with good and impaired（including mild to moderate impaired and severe impaired）function,with a sensitivity of 88.6% and a specificity of 83.1%.Conclusion:T₁-mapping provide valuable information to analyze the difference of cortical T₁-values in different renal allografts function early after transplantation.It could be a useful method for evaluating renal function noninvasively.更多还原