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Effect of BOLD-fMRI on early renal function in patients with type 2 diabetes mellitu
SUN Haizhen  SONG Xueyan  LU Shan 

Cite this article as: SUN H Z, SONG X Y, LU S. Effect of BOLD-fMRI on early renal function in patients with type 2 diabetes mellitu[J]. Chin J Magn Reson Imaging, 2023, 14(7): 61-66. DOI:10.12015/issn.1674-8034.2023.07.011.

[Abstract] Objective To explore the value of blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) in the evaluation of early renal functional hypoxia in patients with type 2 diabetes.Materials and Methods Fifty-five patients with type 2 diabetes were divided into diabetes mellitus group (DM group, n=27) and early diabetic nephropathy group (DN group, n=28) according to the presence or absence of microalbuminuria. Thirty age- and sex- matched healthy volunteers were recruited as normal control group (NC group). The cortical R2* value (cortical R2*, CR2*), medulla R2* value (medullary R2*, MR2*) and medulla/cortical R2* (R2* ratio between medulla and cortex, MCR) were calculated by BOLD-fMRI program scan. The intra-group and inter-group comparative analysis was performed. Then receiver operating characteristic (ROC) are plotted.Results The value of MR2* was significantly higher than that of CR2* in the three groups (all P<0.05). There was no significant difference in CR2* among the three groups (P>0.05), but the values of MR2* and MCR in DM group were significantly higher than those in NC group and early DN group (P<0.05), but there was no significant difference between early DN group and NC group (P>0.05). MR2* value, MCR and MR2*+MCR had good diagnostic value in differentiating NC group from DM group, early DM group and early DN group, the AUC values were 0.884 [95% (confidence interval, CI): 0.802-0.966], 0.802 (95% CI: 0.690-0.915) and 0.891 (95% CI: 0.811-0.971); 0.819 (95% CI: 0.707-0.931), 0.759 (95% CI: 0.630-0.889) and 0.824 (95% CI: 0.714-0.934) respectively. There were no significant difference in diagnostic efficacy among all indexes (P>0.05).Conclusions BOLD-fMRI can non-invasively evaluate the early renal damage in patients with diabetes from the level of oxygenation, and can monitor the functional hypoxia changes of renal medulla in the stage of clinical proteinuria, which provides a basis for early clinical diagnosis, timely treatment and improvement of prognosis, and has important clinical value.
[Keywords] type 2 diabetes mellitus;diabetic nephropathy;renal function;blood oxygen level dependence;differential diagnosis;magnetic resonance imaging

SUN Haizhen1, 2   SONG Xueyan1, 2   LU Shan1, 2*  

1 Department of Radiology, Tianjin Medical University Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, TianJin 300134, China

2 NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, TianJin 300134, China

Corresponding author: Lu S, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Key Laboratory Opening Project of Tianjin Medical University Chu Hsien-I Memorial Hospital (No. ZXY-ZDSYS2020-4).
Received  2023-02-18
Accepted  2023-06-29
DOI: 10.12015/issn.1674-8034.2023.07.011
Cite this article as: SUN H Z, SONG X Y, LU S. Effect of BOLD-fMRI on early renal function in patients with type 2 diabetes mellitu[J]. Chin J Magn Reson Imaging, 2023, 14(7): 61-66. DOI:10.12015/issn.1674-8034.2023.07.011.

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