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Chronic kidney disease: Pathological and functional evaluation with intravoxel incoherent motion diffusion‐weighted imaging
Author(s) -
Mao Wei,
Zhou Jianjun,
Zeng Mengsu,
Ding Yuqin,
Qu Lijie,
Chen Caizhong,
Ding Xiaoqiang,
Wang Yaqiong,
Fu Caixia
Publication year - 2018
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25861
Subject(s) - intravoxel incoherent motion , medicine , pathological , perfusion , diffusion mri , kidney disease , renal function , effective diffusion coefficient , analysis of variance , kidney , medulla , pathology , nuclear medicine , radiology , magnetic resonance imaging , urology
Background Because chronic kidney disease (CKD) is a worldwide problem, accurate pathological and functional evaluation is required for planning treatment and follow‐up. Intravoxel incoherent motion diffusion‐weighted imaging (IVIM‐DWI) can assess both capillary perfusion and tissue diffusion and may be helpful in evaluating renal function and pathology. Purpose To evaluate functional and pathological alterations in CKD by applying IVIM‐DWI. Study Type Prospective study. Subjects In all, 72 CKD patients who required renal biopsy and 20 healthy volunteers. Field Strength 1.5T. Assessment All subjects underwent IVIM‐DWI of the kidneys, and image analysis was performed by two radiologists. The mean values of true diffusion coefficient (D), pseudo diffusion coefficient (D*), and perfusion fraction (f) were acquired from renal parenchyma. Correlation between IVIM‐DWI parameters and estimated glomerular filtration rate (eGFR), as well as pathological damage, were assessed. Statistical Tests One‐way analysis of variance (ANOVA), paired sample t ‐test and Spearman correlation analysis. Results The paired sample t ‐test revealed that IVIM‐DWI parameters were significantly lower in medulla than cortex for both patients and controls ( P < 0.01). Regardless of whether eGFR was reduced, ANOVA revealed that f values of renal parenchyma were significantly lower in patients than controls ( P < 0.05). Spearman correlation analysis revealed that there were positive correlations between eGFR and D (cortex, r = 0.466, P < 0.001; medulla, r = 0.491, P < 0.001), and between eGFR and f (cortex, r = 0.713, P < 0.001; medulla, r = 0.512, P < 0.001). Negative correlations were found between f and glomerular injury (cortex, r = −0.773, P < 0.001; medulla, r = −0.629, P < 0.001), and between f and tubulointerstitial lesion (cortex, r = −0.728, P < 0.001; medulla, r = −0.547, P < 0.001). Data Conclusion IVIM‐DWI might be feasible for noninvasive evaluation of renal function and pathology of CKD, especially in detection of renal insufficiency at an early stage. Level of Evidence : 1 Technical Efficacy : Stage 3 J. Magn. Reson. Imaging 2018;47:1251–1259.