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12.05.2017 | Magnetic Resonance

Diffusion-weighted imaging of the kidneys in haemolytic uraemic syndrome

verfasst von: Jochen Herrmann, Ulrich Wenzel, Stephanie Galler, Bjoern P. Schoennagel, Jasmin D. Busch, Magdalini Tozakidou, Kay U. Petersen, Michaela Joekel, Peter Bannas, Jin Yamamura, Michael Groth, Gerhard Adam, Christian R. Habermann

Erschienen in: European Radiology | Ausgabe 11/2017

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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 (ADC_TOT), and ADCs predominantly reflecting microperfusion (ADC_LOW) and diffusion (ADC_HIGH) were calculated. Doppler US evaluated renal vascularity and flow.

Results

When compared with controls, kidneys affected by HUS showed reduced cortical ADC values (ADC_TOT 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 (ADC_TOT, P<0.001; ADC_LOW, P 0.047). Kidneys with complete absence of the cortical vasculature on Doppler US (four patients) also demonstrated limited diffusion (ADC_HIGH, P 0.002). Low glomerular filtration rate, requirement for haemodialysis during hospitalization, and longer duration of haemodialysis were associated with decreased cortical diffusivity (ADC_TOT: 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.

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Titel: Diffusion-weighted imaging of the kidneys in haemolytic uraemic syndrome
verfasst von: Jochen Herrmann
Ulrich Wenzel
Stephanie Galler
Bjoern P. Schoennagel
Jasmin D. Busch
Magdalini Tozakidou
Kay U. Petersen
Michaela Joekel
Peter Bannas
Jin Yamamura
Michael Groth
Gerhard Adam
Christian R. Habermann
Publikationsdatum: 12.05.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 11/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4848-2

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Diffusion-weighted imaging of the kidneys in haemolytic uraemic syndrome

Abstract

Objectives

Materials and Methods

Results

Conclusion

Key Points

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Abstract

Objectives

Materials and Methods

Results

Conclusion

Key Points

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