中文摘要：

目的：探讨肾脏血氧水平依赖（BOLD）MRI诊断慢性乙型肝炎患者早期肾损害的可行性。方法前瞻性收集经临床化验诊断的慢性乙型肝炎早期肾损害患者17例和10名健康志愿者。17例患者行动态核素肾图检查，分为肾功能损伤1级（7例）和肾功能损伤2级（10例）。所有受试者均行腹部BOLD检查，测量计算皮质T2＊弛豫率（R2^＊）、髓质R2^＊和肾髓质与皮质R2^＊比值（R2^＊髓/皮）。采用单因素方差分析比较对照组、慢性肝炎组（肾功能损伤1、2级）的皮、髓质R2^＊值及R2^＊髓/皮的差异，采用ROC曲线评价皮、髓质R2^＊值及R2^＊髓/皮诊断慢性肝炎患者肾脏损害的效能。结果对照组、肾功能损伤1级组、肾功能损伤2级组患者的皮质R2^＊值分别为（16.87±0.74）、（17.88±0.73）、（20.29±2.87）/s，髓质R2^＊值分别为（28.07±1.03）、（31.14±2.49）、（32.81±3.28）/s，R2^＊髓/皮分别为1.67±0.09、1.75±0.16和1.63±0.13，3组间差异均有统计学意义（F值分别为17.779、19.170和3.439，P均〈0.05），且慢性乙肝患者的皮、髓质R2^＊值均高于对照组，肾功能损伤2级患者的皮质R2^＊值高于1级患者（P均〈0.05）。肾皮质R2^＊值、髓质R2^＊值及R2^＊髓/皮诊断慢性肝炎患者早期肾损伤的ROC下面积分别为0.903、0.949和0.526。结论肾脏BOLD MRI诊断慢性乙型肝炎患者早期肾损害具有可行性和较大价值，肾皮质R2^＊对早期肾损害较髓质R2^＊敏感。

英文摘要：

Objective To explore the feasibility of blood oxygen level-dependent （BOLD） MRI to detect the chronic hepatitis b-induced early kidney injury. Methods Seventeen clinically diagnosed chronic hepatitis b patients with early kidney injury and 10 healthy volunteers were enrolled in this preliminary study. The 17 patients underwent dynamic nuclear renography and then subdivided into stage 1 kidney injury group （n=7） and stage 2 kidney injury group （n=10）. All of the enrolled subjects underwent BOLD examination and T2＊ relaxation rates （R2^＊） of renal cortex and medulla of split kidney, and the ratio between them （R2^＊med/cor） were measured separately. One-way analysis of variance （ANOVA） were performed on the control group and chronic hepatitis b patients group （kidney injury stage 1 and stage 2 group） to compare the difference of renal cortical and medullary R2^＊values and R2^＊med/cor ratio. ROC curves were used to evaluate the efficacy of renal cortical and medullary R2^＊ values and R2^＊med/cor ratio to diagnose the chronic hepatitis b-induced kidney injury. Results The cortical R2^＊values of control group, stage 1 kidney injury group and stage 2 kidney injury group were（16.87 ± 0.74）/s,（17.88 ± 0.73）/s,（20.29 ± 2.87）/s, respectively;the medullar R2^＊values of control group, stage 1 kidney injury group and stage 2 kidney injury group were （28.07±1.03）/s,（31.14±2.49）/s,（32.81±3.28）/s, respectively;R2^＊med/cor of the of control group, stage 1 kidney injury group and stage 2 kidney injury group were 1.67 ± 0.09, 1.75 ± 0.16, 1.63 ± 0.13, respectively, and the differences among the three groups were statistically significant （F values were 17.779, 19.170 and 3.439 , all P〈0.05）. Furthermore, the renal cortical and medullary R2^＊ values of chronic hepatitis b patients were＆amp;nbsp;significantly higher than the control group, and the the renal cortical R2^＊ value of the patients in stage 2 kidney injury group was also higher than