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International Urology and Nephrology

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16.06.2023 | Nephrology - Original Paper

Based on functional and histopathological correlations: is diffusion kurtosis imaging valuable for noninvasive assessment of renal damage in early-stage of chronic kidney disease?

verfasst von: Jiazhen Lin, Caifeng Zhu, Feng Cui, Hua Qu, Yongsheng Zhang, Xianjie Le, Jiazhen Yin, Youjun Cao

Erschienen in: International Urology and Nephrology | Ausgabe 1/2024

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Abstract

Purpose

To evaluate the potential of 3 T magnetic resonance diffusion kurtosis imaging (DKI) in assessing the renal damage in early-stage of chronic kidney disease (CKD) patients with normal or slightly changed functional index, using histopathology as reference standard.

Methods

49 CKD patients and 18 healthy volunteers were recruited in this study. CKD patients were divided into two groups based on estimated glomerular filtration rate (eGFR): Study group I (eGFR ≥ 90 ml/min/1.73 m² [n = 20]) and Study group II (eGFR < 90 ml/min/1.73 m² [n = 29]). DKI was performed in all participants. The DKI parameters (mean kurtosis [MK], mean diffusivity [MD], fractional anisotropy [FA]) of renal cortex and medulla were measured. The differences of parenchymal MD, MK and FA values among the different groups were compared. The correlations between DKI parameters and clinicopathological characteristics were assessed. Diagnostic performance of DKI to assess renal damage in early-stage of CKD was analyzed.

Results

The cortex MD and MK showed significant difference among three groups (P < 0.05): trend of cortex MD: Study group II < Study group I < control group; trend of cortex MK: control group < Study group I < Study group II. The cortex MD and MK and medulla FA were correlated with eGFR and Interstitial fibrosis/Tubular atrophy score (0.3 < r < 0.5). Cortex MD and MK yielded an AUC of 0.752 for differentiating healthy volunteers from CKD patients with eGFR ≥ 90 ml/min/1.73 m².

Conclusion

DKI shows potential in non-invasive and multi-parameter quantitative assessment of renal damage in early-stage of CKD patients and provide additional information for changes in renal function and histopathology.

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Titel: Based on functional and histopathological correlations: is diffusion kurtosis imaging valuable for noninvasive assessment of renal damage in early-stage of chronic kidney disease?
verfasst von: Jiazhen Lin
Caifeng Zhu
Feng Cui
Hua Qu
Yongsheng Zhang
Xianjie Le
Jiazhen Yin
Youjun Cao
Publikationsdatum: 16.06.2023
Verlag: Springer Netherlands
Erschienen in: International Urology and Nephrology / Ausgabe 1/2024
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-023-03632-y

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