目的 探讨BOLD_R2 * 与DWI_ADC值 人体肾移植急性排斥早期诊断价值。方 法 随机选取正常原位肾33例(A组)、正常 移植肾34例(B组)、急性排斥移植肾15例 (C组)为研究对象，应用3.0T扫描仪BOLD 及DWI序列扫描所有志愿者，将图像输至 工作站分析处理。比较三组肾皮质、髓质 R2 * 及与肌肉标准化ADC0-100、ADC0-800值差异 性，P＜0.05为有统计学差异。以病理为 “金标准”，评价髓质R2 * 及与肌肉标准化 皮质ADC0-100、ADC0-800值鉴别急性排斥移植 肾与移植正常肾、正常原位肾诊断效能。 结果 (1)三组间肾髓质R2 * 差异有统计学意 义，两两比较发现C组R2 * 明显低于与A、B 组，A与B组间无统计学差异；三组间肾皮 质R2 * 差异无统计学意义。以病理为标准， 髓质R2 * =22.7hz为界值，BOLD_R2 * 区别急 性排斥与移植正常肾、原位正常肾ROC曲 线下面积为0.981,SE和SP分别为93.3%和 100%。(2)三组间肾皮质标准化ADC0-100、 ADC0-800值有统计学意义，两两比较除A与B 组间差异无统计学意义外其余组间有统计 学意义。三组间髓质ADC0-100、ADC0-800值无 统计学意义。以病理为标准，取1.249、 1.122为界值，标准化皮质ADC0-100、ADC0-800 诊断急性排斥移植肾ROC曲线下面积分别 为0.947、0.978，SE、SP分别为83.3%、 86.7%，91.1%、92.3%。结论 BOLD与DWI 在肾移植急性排斥早期诊断中有重要价 值，可为后期治疗提供可靠影像依据。

Objective To perspectively investigate the value of BOLD_R2 * and DWI_ ADC in monitoring human renals with early acute rejection. Methods 33 cases of healthy kidneys in situ (group A), 34 cases of normal renal allograft (group B) and 15 cases of renals with acute rejection (group C) who underwent BOLD and DWI procedure at 3.0T were selected as the research objects. The datas were transfered into the workstation for processing after MRI. The measurements of R2 * and ADC0-100, ADC0-800 standardized with muscle on renal cortex, medulla were obtained among the three groups, P<0.05 was difference significant. According to the pathological biopsy, the values of BOLD_R2 * and DWI_ADC standardized to differencitae the kidneys with acute rejection were assessed by ROC curve. Results There were statistic significance for R2 * on renal medulla among the three groups(P<0.05), however no statistic significances were found for medullary R2 * between group A and B; While no statistic significances were found for cortical R2 * among the three groups(P＞0.05). With an area under the ROC curve of R2 * =22.7hz as diagnose critical points, the sensibility was 93.3%, the specificity was 100%, and the accuracy was 0.981 in the prediction of the kidneys with acute rejection. There were statistic significance for cortical standardized ADC0-100, ADC0-800 within groups(P<0.05), however no statistic significances were found for cortical standardized ADC0-100, ADC0-800 between group A and B; while no statistic significances were found for medullary standardized ADC0-100, ADC0-800 among three groups(P＞0.05). With an area under the ROC curve of ADC0-100=1.249、ADC0-800=1.122 as diagnose critical points, the sensibility was 83.3% and 86.7%, the specificity was 91.1% and 92.3%, and the accuracy was 0.947 and 0.978 in the prediction of the transplanted renals with acute rejection, respectively. Conclusion BOLD and DWI is of important value in the early diagnosis of renal acute rejection, which can provide reliable imaging evidence for later treatment.