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目的:探究n 68Ga-1，4，7，10-四氮杂环十二烷-1，4，7，10-四乙酸(DOTA)-成纤维细胞激活蛋白抑制剂(FAPI)-04 PET/CT在评估不同病理分级肾纤维化患者中的价值。n 方法:回顾性分析2020年9月至2021年8月期间在西南医科大学附属医院确诊肾纤维化的患者25例[男11例、女14例，年龄(39.3±13.9)岁]，所有患者接受了肾脏穿刺检查及n 68Ga-DOTA-FAPI-04 PET/CT检查。以患者肾脏穿刺检查得到的病理结果作为“金标准”，将患者分为轻度纤维化(Ⅰ)、中度纤维化(Ⅱ)、重度纤维化(Ⅲ)。同时纳入接受n 68Ga-DOTA-FAPI-04 PET/CT检查示双侧肾脏未有放射性异常摄取且无泌尿系统相关病史的患者20例[男10例、女10例，年龄(47.5±13.2)岁]作为正常对照组。收集患者相关参数，包括双肾最大标准摄取值(SUVn max)、肝脏平均标准摄取值(SUVn mean)、靶/本底比值(TBR)、肾小球滤过率(GFR)、血清肌酐(Scr)。采用Kruskal-Wallis秩和检验和Bonferroni校正法比较不同分组患者的肾脏SUVn max、肝脏SUVn mean、TBR和Scr，采用单因素方差分析和最小显著差异n t检验比较不同分组患者的GFR。采用受试者工作特征(ROC)曲线评价肾脏SUVn max对肾纤维化的诊断效能。n 结果:25例肾纤维化患者中，22例显像剂摄取增高，n 68Ga-DOTA-FAPI-04 PET/CT诊断肾纤维化的灵敏度为88%。肾纤维化分级Ⅰ、Ⅱ、Ⅲ患者的肾脏SUVn max、TBR显著高于对照组[SUVn max：4.40(3.30，4.50)、5.90(4.28，6.48)、8.50(7.50，9.73)和1.44(1.38，1.68)；TBR：6.340±2.389、8.097±1.420、11.343±2.002和2.986±0.645；n H值：33.685, 32.368，调整后均n P<0.05(Bonferroni校正法)]；分级Ⅰ、Ⅲ患者的Scr差异有统计学意义[70.1(55.4，92.5)和174.1(161.4，498.2) μmol/L；n H＝9.770，调整后n P<0.05(Bonferroni校正法)]；分级Ⅱ、Ⅲ患者的肝脏SUVn mean显著高于对照组[0.673±0.129、0.751±0.170和0.514±0.142；n H＝15.609，调整后均n P<0.05(Bonferroni校正法)]；分级Ⅲ患者的GFR与分级Ⅰ、Ⅱ患者的差异有统计学意义[(27.867±15.747)、(87.756±31.657)和(63.160±29.556) ml/min；n F＝8.298，均n P<0.05]。ROC曲线分析示，肾脏SUVn max诊断肾纤维化的曲线下面积为0.946 7(95% n CI：0.899 6~0.993 8，n P<0.001)。n 结论:68Ga-DOTA-FAPI-04 PET/CT对评估肾纤维化程度具有一定的诊断潜力，可作为临床诊断肾纤维化的补充检查手段。n “,”Objective:To evaluate the value of n 68Ga-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid (DOTA)-fibroblast activating protein inhibitor (FAPI)-04 PET/CT on assessing different pathological grades in patients with renal fibrosis.n Methods:A total of 25 patients (11 males, 14 females; age (39.3±13.9) years) diagnosed with renal fibrosis in the Affiliated Hospital of Southwest Medical University from September 2020 to August 2021 were retrospectively analyzed. All patients underwent renal puncture examination and n 68Ga-DOTA-FAPI-04 PET/CT examination. The pathological results of kidney puncture were as the “ gold standard” to divide the patients into mild fibrosis (Ⅰ), moderate fibrosis (Ⅱ), and severe fibrosis (Ⅲ). At the same time, 20 patients (10 males, 10 females; age (47.5±13.2) years) who underwent n 68Ga-DOTA-FAPI-04 PET/CT examination showed no abnormal uptake of radioactivity in bilateral kidneys and no history of urinary system related diseases were enrolled as normal controls. Parameters including the maximum standardized uptake value (SUVn max) of both kidneys, the mean standardized uptake value (SUVn mean) of the liver, target/background ratio (TBR), glomerular filtration rate (GFR), and serum creatinine (Scr) were collected. Kruskal-Wallis rank sum test and Bonferroni correction method were used to compare the differences of SUVn max, SUVn mean, TBR and Scr among groups. One-way analysis of variance and least significant difference (LSD) n t test were used to compare the difference of GFR among groups. The receiver operating characteristic (ROC) curve analysis was used to analyze the diagnostic efficacy of SUVn max for the degree of renal fibrosis.n Results:Of 25 patients, 22 had increased imaging agent uptake and the sensitivity of n 68Ga-DOTA-FAPI-04 PET/CT in diagnosing renal fibrosis was 88%. The SUVn max and TBR of patients with fibrosis grade Ⅰ, Ⅱ and Ⅲ were significantly higher than those of controls (SUVn max: 4.40(3.30, 4.50), 5.90(4.28, 6.48), 8.50(7.50, 9.73) and 1.44(1.38, 1.68); TBR: 6.340±2.389, 8.097±1.420, 11.343±2.002 and 2.986±0.645; n H values: 33.685, 32.368, all adjusted n P<0.05 (Bonferroni correction method)). The Scr of patients with fibrosis grade Ⅰ and Ⅲ were significantly different (70.1(55.4, 92.5) and 174.1(161.4, 498.2) μmol/L;n H=9.770, adjusted n P<0.05 (Bonferroni correction method)). The liver SUVn mean of patients with renal fibrosis grades Ⅱ and Ⅲ were significantly higher than that of controls (0.673±0.129, 0.751±0.170 and 0.514±0.142; n H=15.609, both adjusted n P<0.05 (Bonferroni correction method)). The GFR of patients with fibrosis grade Ⅲ had significant differences with grade Ⅰ and Ⅱ ((27.867±15.747), (87.756±31.657) and (63.160±29.556) ml/min;n F=8.298, both n P<0.05). ROC curve analysis showed that the area under curve was 0.946 7 (95%n CI: 0.899 6-0.993 8, n P<0.001).n Conclusion:68Ga-DOTA-FAPI-04 PET/CT has a certain value in evaluating the degree of renal fibrosis, which can be used as a supplementary examination method for diagnosing renal fibrosis.n