MRI成像对维持性血液透析患者脑损害的评估价值

目的研究维持性血液透析患者脑损害使用磁共振成像(MRI)成像的评估价值。方法回顾性选择我院2014年5月至2019年5月收治的维持性血液透析伴脑损害患者28例作为病例组,并根据影像学检查结果分为轻度组13例和中重度组15例,再选择同期、同时间段、同性别健康体检人群30例作为对照组。观察病例组和对照组颅脑额叶、顶枕叶、颞叶、幕下、基底节、半卵圆中心区域表观弥散系数(ADC)、各向异性分数(FA)均值,并分析ADC、FA值与疾病严重程度相关性。结果病例组、轻度组、中重度组与对照组颞叶、幕下区域ADC值差异无统计学意义(P>0.05),病例组、轻度组、中重度组与对照组额叶、顶枕叶、基底节、半卵圆中心区域ADC值差异有统计学意义(P<0.05)。病例组、轻度组、中重度组与对照组幕下区域FA值差异无统计学意义(P>0.05),病例组、轻度组、中重度组与对照组额叶、顶枕叶、颞叶、基底节、半卵圆中心区域FA值差异有统计学意义(P<0.05)。ADC值与额叶、顶枕叶、基底节、半卵圆中心区域病变严重程度呈正相关(r额叶=0.732,P额叶=0.000;r顶枕叶=0.545,P顶枕叶=0.000;r基底节=0.710,P基底节=0.000;r半卵圆中心=0.623,P半卵圆中心=0.000),FA值与额叶、顶枕叶、颞叶、基底节、半卵圆中心区域病变严重程度呈负相关(r额叶=-0.624,P额叶=0.000;r顶枕叶=-0.712,P顶枕叶=0.000;r颞叶=-0.336,P颞叶=0.012;r基底节=-0.536,P基底节=0.000;r半卵圆中心=-0.553,P半卵圆中心=0.000)。结论维持性血液透析患者脑损伤使用MRI检查能提供量化指标,且病变程度与ADC值、FA值间相关性较好,为诊断提供客观指标的同时有助于疾病临床诊断。

Evaluation Value of MRI for Brain Damage of Patients Undergoing Maintenance Hemodialysis

Objective To study evaluation value of magnetic resonance imaging(MRI) for brain damage of patients undergoing maintenance hemodialysis(MHD).Methods A retrospective selection was performed on28 patients with brain damage undergoing MHD who were admitted to the hospital from May 2014 to May 2019,and they were enrolled as case group.According to imaging examination results,they were divided into mild group(13 cases) and moderate-to-severe group(15 cases).30 healthy people with the same gender in the same period who underwent physical examination were enrolled as control group.The appa rent diffusion coefficient(ADC) and fra ctional anisotropy(FA) of cra niocerebral frontal lobe,parietal and occipital lobe,temporal lobe,subtentorium,basal ganglia and semi-oval center areas in case group and control group were observed.The correlation between ADC,FA and disease severity was analyzed.Results There was no significant difference in ADC value of temporal lobe or subtentorium area among case group,mild group,moderate-to-severe group and control group,while there we re significant differences in ADC value of frontal lobe,pa rietal and occipital lobe,basal ganglia and semi-oval center a reas among the above 4 groups(P<0.05).The re was no significa nt difference in FA value of subtentorium area among the 4 groups(P>0.05).There were significant differences in FA value of frontal lobe,parietal and occipital lobe,temporal lobe,basal ganglia and semi-oval center areas among the above 4 groups(P<0.05).ADC value was positively correlated with severity of lesions in frontal lobe,parietal and occipital lobe,basal ganglia and semi-oval center areas(r frontal lobe=0.732,P frontal lobe=0.000.r parietal and occipital lobe=0.545,P parietal and occipital lobe=0.000.r basal ga nglia=0.710,P basal ganglia=0.000.r semi-oval center=0.623,P semioval center=0.000),while FA value was negatively correlated with severity of lesions in frontal lobe,parietal and occipital lobe,basal ganglia and semi-oval center areas(r frontal lobe=0.624,P frontal lobe=0.000.r parietal and occipital lobe=0.712,P parietal and occipital lobe=0.000.r temporal lobe=-0.336,P temporal lobe=0.012.r basal ga nglia=0.536,P basal ganglia=0.000.r semi-oval center=0.553,P semi-oval center=0.000).Conclusion MRI examination for brain damage patients undergoing MHD can provide quantitative indexes The correlation between lesion degree and ADC value,FA value is good,which provides objective indexes for diagnosis and contributes to clinical diagnosis of diseases.