Böbreğin kronik parankimal hastalıklarında diffüzyon tensör görüntüleme ve traktografi
Küçük Resim Yok
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamız kronik böbrek hastalığı olan ve böbrek hastalığı olmayan olgularda DTG parametrelerinin değerlendirmesi ve karşılaştırılması şeklinde planlandı. Gönüllü olarak 60 kişi ve hasta grubu olarak 60 kişi çalışmaya dahil edildi. GFH baz alınarak 60 kişi hasta grubu Böbrek/Diyaliz Sonuc Kalite Girişimi (NKFK/DOQI) kılavuzlarına göre 5 altgruba bölündü. DTG, echo-planar inceleme ile 6 non-collinear yönde diffüzyon sensitizasyon gradiyenti (b=500 s/mm²) uygulanarak elde edildi. Bu çalışmanın amacı DTG kullanarak, böbreğin kronik parankim hastalığı evrelerinde ADC ve FA değerlerindeki değişiklikleri saptamak, klinik ve laboratuvar bulguları ile karşılaştırmaktır. Ayrıca böbreğin kronik parankim hastalığı değerlendirilmesi ve takibinde DTG' nin noninvaziv bir araç olarak kullanılma potansiyelinin araştırılmasıdır. ADC ve FA ölçümleri çekim sonrası oluşturulan haritalardan ROI ölçümü ile yapıldı. Her grupta böbrek korteksi ve medüllasında ADC ve FA değerleri ölçülüp ANOVA testi ile kortikal ve medülla FA ve ADC değerleri karşılaştırıldı. p < 0.05 istatistiksel anlamlı fark olarak kabul edildi. Kontrol ve hasta gruplarında ortalama kortikal ADC değerleri medülladan, ortalama medülla FA değerleri de korteksten daha yüksek olduğu istatistiksel açıdan anlamlı olarak gösterildi (p <0,05). Çalışmamızda her iki böbrek üç düzeyde hasta grupları ve altgruplar arasında ADC ve FA değerleri karşılaştırıldı ve istatistiksel olarak anlamlı sonuç bulunamadı (p>0,05). Mevcut literatürde olduğu gibi kortikal ADC ve medülla FA değerleri GFH ile pozitif yönde kolerasyon gösterdiği saptandı. Ancak bu ilişki istatistiksel olarak anlamlı bulunmadı. Sonuç olarak böbreğin kronik parankim hastalığının değerlendirme ve takibinde özellikte evre 1 ve 2' de DTG ve medülleri FA değeri ölçümü esas olarak noninvaziv bir araç olarak kullanılabilir. Ayrıca traktografi kronik parankim hastalığı ileri evrelerinin değerlendirmesinde yararlı bir araçtır. Anahtar kelimeler: Difüzyon tensor görüntüleme, kronik böbrek parankim hastalığı, görünür difüzyon katsayısı, fraksiyonel anizotropi
Our research has been planned for evaluation and comparing diffusion tensor imaging "DTI" results of control volunteer group with chronic renal patients group. Sixty patients with impaired renal dysfunction (study group) and sixty volunteer without renal disease (control group) were studied. According to NKFK/DOQI guidelines based on GFR amounts, patients were classified in five subgroupes. Diffusion tensor images were evaluated utilizing single-shot echo-planar imaging, applying 6 non-co-linear directions of diffusion sensitization gradients (b=500s/mm2). The aim of this study was evaluating correlation between ADC and FA values between different stages of chronic renal parenchymal disease and laboratory and clinical results. Moreover, possibility of using DTI as a potential non-invasive tool was evaluated. ADC and FA values were measured with ROI measurements from maps created after MRI examination. Renal cortex and medullary ADC and FA values were measured including both control and study group, ANOVA test was performed. Cortical and medulla FA and ADC values were compared (p <0.05). Test results showed statistically significant difference between two groups. In both control and patient group mean ADC value was significantly higher in the cortex than in the medulla, reversely the mean FA value was significantly higher in the medulla than cortex (p< 0.05). Comparison between the two groups showed that the FA value in the medulla was significantly lower in the study group than in the control group (p< 0.05). This result was observed merely in middle and lower pole of kidney, while it was not observed in upper pole of investigated kidneys. There was no significant differences for the cortical and medullary ADC and FA values between the control group and study group. As in literature, our study demonstrated positive correlation between cortical ADC values, medullar FA values and GFR. However, this relationship was not statistically significant. In conclusion, DTI and medullary FA values can be used as a useful non-invasive tool for evaluation, screening and follow up in the early stages of chronic renal disease (stage1 and 2). Whereas tractography is a useful tool for evaluation advanced stages of chronic renal disease. Keywords: Diffusion tensor imaging. chronic renal disease, apparent diffusion coefficient, fractional anisotropy.
Our research has been planned for evaluation and comparing diffusion tensor imaging "DTI" results of control volunteer group with chronic renal patients group. Sixty patients with impaired renal dysfunction (study group) and sixty volunteer without renal disease (control group) were studied. According to NKFK/DOQI guidelines based on GFR amounts, patients were classified in five subgroupes. Diffusion tensor images were evaluated utilizing single-shot echo-planar imaging, applying 6 non-co-linear directions of diffusion sensitization gradients (b=500s/mm2). The aim of this study was evaluating correlation between ADC and FA values between different stages of chronic renal parenchymal disease and laboratory and clinical results. Moreover, possibility of using DTI as a potential non-invasive tool was evaluated. ADC and FA values were measured with ROI measurements from maps created after MRI examination. Renal cortex and medullary ADC and FA values were measured including both control and study group, ANOVA test was performed. Cortical and medulla FA and ADC values were compared (p <0.05). Test results showed statistically significant difference between two groups. In both control and patient group mean ADC value was significantly higher in the cortex than in the medulla, reversely the mean FA value was significantly higher in the medulla than cortex (p< 0.05). Comparison between the two groups showed that the FA value in the medulla was significantly lower in the study group than in the control group (p< 0.05). This result was observed merely in middle and lower pole of kidney, while it was not observed in upper pole of investigated kidneys. There was no significant differences for the cortical and medullary ADC and FA values between the control group and study group. As in literature, our study demonstrated positive correlation between cortical ADC values, medullar FA values and GFR. However, this relationship was not statistically significant. In conclusion, DTI and medullary FA values can be used as a useful non-invasive tool for evaluation, screening and follow up in the early stages of chronic renal disease (stage1 and 2). Whereas tractography is a useful tool for evaluation advanced stages of chronic renal disease. Keywords: Diffusion tensor imaging. chronic renal disease, apparent diffusion coefficient, fractional anisotropy.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Radyoloji ve Nükleer Tıp, Radiology and Nuclear Medicine
