12.05.2017 | Magnetic Resonance | Ausgabe 11/2017
Diffusion-weighted imaging of the kidneys in haemolytic uraemic syndrome
- Zeitschrift:
- European Radiology > Ausgabe 11/2017
Wichtige Hinweise
Electronic supplementary material
The online version of this article (doi:10.1007/s00330-017-4848-2) contains supplementary material, which is available to authorized users.
Abstract
Objectives
To evaluate the kidneys of patients with haemolytic uraemic syndrome (HUS) using diffusion-weighted imaging (DWI) and Doppler ultrasound (US) compared with healthy controls.
Materials and Methods
Fifteen patients (mean age 33.3 years; three male; 12 female) with diarrhoea-positive HUS and 15 healthy volunteers were prospectively evaluated with DWI and Doppler US. A total apparent diffusion coefficient (ADCTOT), and ADCs predominantly reflecting microperfusion (ADCLOW) and diffusion (ADCHIGH) were calculated. Doppler US evaluated renal vascularity and flow.
Results
When compared with controls, kidneys affected by HUS showed reduced cortical ADC values (ADCTOT 1.79±0.22 vs. 2.04±0.1x10-3 mm2/s, P 0.001), resulting in either low corticomedullary differences (11/15 patients) or an inverted corticomedullary pattern (4/15 patients). Reduction of cortical ADC values was associated with a decrease of cortical vascularity on Doppler US (ADCTOT, P<0.001; ADCLOW, P 0.047). Kidneys with complete absence of the cortical vasculature on Doppler US (four patients) also demonstrated limited diffusion (ADCHIGH, P 0.002). Low glomerular filtration rate, requirement for haemodialysis during hospitalization, and longer duration of haemodialysis were associated with decreased cortical diffusivity (ADCTOT: P 0.04, 0.007, and <0.001, respectively).
Conclusion
DWI shows qualitative and quantitative abnormalities in kidneys affected by HUS, thereby extending the non-invasive assessment of renal parenchymal damage.
Key Points
• In HUS, DWI is feasible for functional characterization of kidney involvement.
• Kidneys affected by HUS showed reduced cortical diffusivity.
• Decreased cortical diffusivity was associated with lower kidney function.
• Requirement and duration of haemodialysis was linked to degree of cortical alterations.
