对照CT增强扫描探讨扩散张量成像对疑似慢性肾盂肾炎的诊断价值

摘要

目的：探讨以多层螺旋CT（ MSCT）增强扫描为参考标准，分析慢性肾盂肾炎患者肾脏皮、髓质ADC值和FA值改变，评估扩散张量成像（ DTI）在慢性肾盂肾炎诊断中的价值。方法临床高度疑诊慢性肾盂肾炎患者44例1周内分别接受MDCT增强扫描和DTI扫描，根据所订标准将肾脏MSCT增强扫描结果评定为正常或者异常，即分为CT阳性组和CT阴性组。随机选取20名健康志愿者作为对照组进行DTI扫描。结果44例疑诊慢性肾盂肾炎患者经MSCT增强检查CT阳性组26例，CT阴性组18例。44例疑诊患者皮、髓质ADC值和FA值均出现了不同程度降低。三组间比较皮、髓质ADC值均无统计学差异（ P ＞0．05），三组间比较皮质FA值差异有统计学意义（ P ＜0．05），正常对照组与CT阳性组髓质FA值比较有统计学差异（ P ＜0．05），正常对照组与CT阴性组比较差异无统计学意义（ P ＞0．05），CT阴性组与阳性组间比较差异有统计学意义（ P ＞0．05）。结论慢性肾盂肾炎的DTI研究中髓质FA值较ADC值敏感，髓质FA值降低能一定程度的反映慢性肾炎肾炎的病理情况和功能变化。%Objective Compared with the standard of multislice spiral CT, Renal cortex, medulla ADC and FA value were analyzed in patients with suspected chronic pyelonephritis.To investigate the value of DTI in chronic pyelonephritis patients. Methods 44 patients with suspected chronic pyelonephritis in our hospital were selected as test group, who were all given MSCT contrast enhanced scan and DTI within one week.The results of MSCT contrast enhanced scan were assessed as normal or abnor-mal according to the set standard, That is divided into CT positive group and CT negative group.Collect 20 cases of normal volun-teers as control group.Results 44 cases of suspected chronic pyelonephritis underwent enhanced MSCT scan.Results 28 of the 44 cases were positive and 16 were negative.Renal cortex, medullary ADC, FA values all were decreased in different degree.Re-nal cortex ADC and FA values were not statistically significant among the 3 groups ( P >0.05) .Medulla FA value was statisti-cally significant between healthy volunteers group and CT positive group ( P <0.05) .Medulla FA value was statistically signifi-cant between CT positive group and negative group ( P <0.05).Medulla FA value was not statistically significant between healthy volunteers group and CT negative group ( P >0.05).Conclusion This study on magnetic resonance diffusion tensor im-aging ( DTI) shows Medulla FA value is more sensitive than ADC value in chronic pyelonephritis.Reduced FA values of renal mesulla indicate DTI can reflect physiology characteristic and function change of the chronic pyelonephritis to a certain extent.