Objective To explore the application value of functional magnetic resonance imaging in the diagnosis of elderly diabetic nephropathy.Methods A total of 80 older adult patients with diabetic nephropathy admitted at Wenzhou Central Hospital between May 2020 and May 2023 and 80 healthy volunteers were prospectively enrolled as observation group and control group respectively.All subjects underwent examinations of blood oxygen level dependent-functional magnetic resonance imaging(BOLD-MRI)and intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)to detect estimated glomerular filtration rate(eGFR).The diagnostic value of functional magnetic resonance imaging in patients with diabetic nephropathy was evaluated by receiver operating characteristic(ROC)curves.The relationship between imaging parameters and eGFR level in patients with diabetic nephropathy was analyzed by Pearson correlation analysis.Results The apparent spin-spin relaxation(R2*)values of the medulla and cortex in the observation group were greater than those in the control group(t=7.99,3.50,P＜0.05).The area under the ROC curve(AUC)of medulla R2*in the diagnosis of diabetic nephropathy was greater than that of cortex R2*(0.885 vs.0.734,Z=2.24,P＜0.05).The IVIM pure diffusion coefficient(D value)and perfusion fraction(f value)of renal medulla and cortex in the observation group were lower than those in the control group(t=8.73,11.24,6.59,9.52,P＜0.05).AUC values of cortex D and f in the diagnosis of diabetic nephropathy were 0.893 and 0.911 respectively,greater than those of medulla D and f(0.808 and 0.793 respectively;Z=1.99,2.14,P＜0.05).The results of Pearson correlation analysis showed that eGFR level was negatively correlated with BOLD R2*of renal medulla and cortex(r=-0.31,-0.48,P＜0.05),while positively correlated with D and f of medulla and cortex(r=0.48,0.44,0.39,0.33,P＜0.05).Conclusion BOLD-MRI and IVIM-DWI can reflect renal changes in patients with diabetic nephropathy from different aspects such as renal oxygenation,perfusion and water molecular diffusion,which can be applied in the early diagnosis of renal damage and non-invasive observation of renal function changes in older adult patients with diabetes mellitus.
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