目的 探讨维持性透析患者脑白 质变性3.0TMRI弥散功能成像的表现及特 点，评估弥散功能成像对其诊断及分级的 价值。方法 108例终末肾病期(ESRD)患者 作为研究组，34例健康体检者作为对照 组，分别进行常规MR、DWI、DTI检查，研 究组按年龄相关白质改变(ARWMC)分级标 准分为三个级别，与对照组及各级别之间 两两进行统计学比较。结果 维持性透析 患者脑白质变性区表观扩散系数(ADC)值 升高，各向异性分数(FA)值下降，研究组 双侧额叶、顶枕叶各级脑白质变性的ADC 值与对照组均存在统计学差异(P<0.05)， 其各级脑白质变性ADC值之间亦存在统计 学差异(P<0.05)。三级脑白质变性者双侧 基底节区ADC值与对照组、一、二级存在 统计学差异(P<0.05)；研究组双侧半卵圆 中心、侧脑室旁各级脑白质变性的FA值与 对照组均存在统计学差异(P<0.05)，其各 级脑白质变性FA值之间亦存在统计学差异 (P<0.05)。三级脑白质变性者双侧内囊 FA值与对照组、一、二级存在统计学差异 (P<0.05)。研究组双侧额叶、顶枕叶脑白 质变性的ADC值与变性级别呈正相关性； 双侧半卵圆中心、侧脑室旁脑白质变性的 FA值与变性级别呈负相关性。结论 弥散 功能成像可客观、敏感、数据化的反映维 持性透析患者脑白质变性的特点及程度。

Objective To investigate the expression and characteristics of maintenance dialysis patients with white matter degeneration by 3.0TMRI diffusion functional imaging, and to evaluate the value in the diagnosis and classification of them. Methods 108 cases of end-stage renal disease (ESRD) patients as study group, 34 cases of healthy persons as control group, they were respectively conventional MR, DWI and DTI examined. Study group according to age related white matter changes (ARWMC) grading standards were divided into three grades, control group and the grades between pairwise statistical comparisons were performed. Results Maintained dialysis patients with white matter degeneration ADC values increased, decreased FA. The bilateral frontal, top pillow leaf of all grades of the white matter degeneration of ADC values and control group there were significant difference (P<0.05), between the grades of white matter degeneration ADC values also exist statistical difference (P<0.05). Three grades of white matter degeneration in bilateral basal ganglia ADC value and the control group, the first, secondary grades were existed statistical difference (P<0.05); study group of bilateral centrum semiovale, periventricular all l grades of the white matter degeneration of FA values and control group were significant difference (P<0.05), between the grades of degeneration of white matter FA values also were existed statistical difference (P<0.05). The third grade myelinopathy in bilateral anterior FA value was significant difference in the control group, the first, secondary grades (P<0.05). The ADC value of bilateral frontal lobe and occipital lobe of the study group was positively correlated with the level of degeneration. The FA value of the bilateral semi oval center and the white matter degeneration of the lateral ventricles were negatively correlated with the degeneration level. Conclusion Diffusion functional imaging can be objectively, sensitively reflected the characteristics and extent of white matter degeneration in maintenance dialysis patients.