Kronik Böbrek Hastalığında Renal Steatozun ve Klinik Evre ile İlişkisinin Kimyasal Şift MRG ile Kantitatif Olarak Değerlendirilmesi

Öz

Amaç: Kronik böbrek hastalığında renal parankimal lipid birikiminin kantitatif olarak kimyasal şift manyetik rezonans görüntüleme ile ölçülmesi ve klinik evreler ile ilişkisinin değerlendirilmesi amaçlandı

Gereç ve Yöntemler: Bu retrospektif çalışmada gruplar kronik böbrek hastalığı (n=46), kronik böbrek hastalığı olmayan diyabet hastaları (n=31) ve kontrol (n=59) olarak tasarlandı. Kronik böbrek hastalığı grubu kendi içinde diyabetik kronik böbrek hastalığı (n=25) ve non-diyabetik kronik böbrek hastalığı (n=21) olarak iki alt gruba ayrıldı. Yüz otuz altı hastanın toplam 272 böbreği değerlendirildi. Kronik böbrek yetmezliği klinik evrelemesi e-GFR değerlerine göre yapıldı. Tüm manyetik rezonans incelemeleri 1.5 Tesla cihazla yapıldı. Böbrek parankimindeki yağ miktarını ölçmek için, kimyasal şift görüntüleme (Faz içi, faz dışı, Dixon-su ve Dixon-yağ) sekansları kullanıldı. Böbrek ve dalaktan, tüm parankim (Birinci yöntem) ve fokal parankimal (İkinci yöntem) olmak üzere, iki farklı yöntemle ölçümler yapıldı. Yağ fraksiyonu ve dalak-böbrek kimyasal şift görüntüleme oranı hesaplandı.

Bulgular: Birinci ve ikinci ölçüm yöntemlerine göre, kontrol grubunda parankimal yağ fraksiyonu değerleri sırasıyla 0.05±0.01 ve 0.05±0.02 olarak hesaplandı. Kronik böbrek hastalığı gruplarında ise yağ fraksiyonu ölçümleri sırasıyla 0.07±0.02 ve 0.07±0.04 olup, kontrol grubuna göre kronik böbrek hastalığı Evre 3’ten itibaren anlamlı yüksek bulundu (p<0.001). Diyabet hastalarında yağ fraksiyonu ve dalak-böbrek kimyasal şift görüntüleme oranı değerlerinde anlamlı farklılık gözlenmedi (p>0.05).

Sonuç: Kronik böbrek hastalığında renal parankimde evre 3’ten itibaren, kontrol grubu ve diyabetik hastalara göre anlamlı lipid birikimi olmaktadır.

Anahtar Kelimeler

• Manyetik rezonans görüntüleme
• kronik böbek hastalığı
• diabetes mellitus

QUANTITATIVE ASSESSMENT OF RENAL STEATOSIS AND ITS RELATIONSHIP WITH CLINICAL STAGE IN CHRONIC RENAL FAILURE USING CHEMICAL SHIFT MRI

Öz

Objective: Quantitative measurement of renal parenchymal lipid accumulation in chronic renal disease using chemical shift magnetic resonance imaging and evaluation of its relationship with clinical stages.

Material and Methods: In this retrospective study, the groups were designed as in chronic renal disease (n=46), diabetes without chronic renal disease (n=31), and control (n=59). Chronic renal disease group also divided into two subgroups as diabetic chronic renal disease (n=25) and non-diabetic chronic renal disease (n=21). A total of 272 kidneys of 136 patients were evaluated. Chronic renal disease clinical staging was performed according to e-GFR values. All magnetic resonance imaging examinations were performed with a 1.5 Tesla device. Chemical shift imaging was used in this study to quantify fat in the renal parenchyma (in-phase, out-of-phase, Dixon-water and Dixon-fat). Measurements were made from kidney and spleen by two different methods as whole parenchyma (first method) and focal parenchymal (second method). The fat fraction, and spleen-to-renal chemical shift imaging ratio were calculated.

Results: In the control group, parenchymal fat fraction according to first and second measurement methods were calculated as 0.05±0.01 and 0.05 ± 0.02, respectively. In the chronic renal disease groups, fat fraction measurements were 0.07±0.02 and 0.07±0.04, respectively, and they were found to be significantly higher from chronic renal disease stage 3 compared to the control group (p<0.001). No significant difference was observed in fat fraction and spleen-to-renal chemical shift imaging ratio values in diabetes patients (p>0.05).

Conclusion: In chronic renal disease, starting from stage 3, there is a significant renal parenchymal lipid accumulation compared to the control group and diabetic patients.

Anahtar Kelimeler

• Magnetic resonance imaging
• chronic renal disease
• diabetes mellitus

Kaynakça

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