Detection of Renal Hypoxia in Lupus Nephritis Using Blood Oxygen Level-Dependent MR Imaging: A Multiple Correspondence Analysis

Shi, Huimin; Yan, Tiekun; Liu, Dong; Jia, Junya; Shang, Wenjun; Li, Wei; Zhao, Zheng

doi:10.1159/000472720

Cited by 16 publications

(15 citation statements)

References 36 publications

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“…17,18 Besides MRE, there are other promising quantitative magnetic resonance imaging (MRI) techniques that have been used for the detection of renal diseases, [24][25][26] including diffusion-weighted imaging (DWI) and blood oxygen level-dependent (BOLD) imaging. [27][28][29] Diffusion-weighted imaging quantifies the diffusivity of water molecules based on the apparent diffusion coefficient (ADC). 30,31 Blood oxygen level-dependent imaging detects changes in inhomogeneous transverse relaxation time T2* due to paramagnetic effects of deoxyhemoglobin, which provide information on the oxygen context of the tissue.…”

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confidence: 99%

Multiparametric Quantitative MRI for the Detection of IgA Nephropathy Using Tomoelastography, DWI, and BOLD Imaging

Lang¹,

Guo²,

Bruns³

et al. 2019

Invest Radiol

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Objectives: The aim of this study was to noninvasively evaluate changes in renal stiffness, diffusion, and oxygenation in patients with chronic, advanced stage immunoglobulin A nephropathy (IgAN) by multiparametric magnetic resonance imaging using tomoelastography, diffusion-weighted imaging (DWI), and blood oxygen level-dependent (BOLD) imaging. Materials and Methods: In this prospective study, 32 subjects (16 patients with biopsy-proven IgAN and 16 age-and sex-matched healthy controls) underwent multifrequency magnetic resonance elastography with tomoelastography postprocessing at 4 frequencies from 40 to 70 Hz to generate shear wave speed (meter per second) maps reflecting tissue stiffness. In addition, DWI and BOLD imaging were performed to determine the apparent diffusion coefficient in square millimeter per second and T2* relaxation time in milliseconds, respectively. Regions including the entire renal parenchyma of both kidneys were analyzed. Areas under the receiver operating characteristic (AUCs) curve were calculated to test diagnostic performance. Clinical parameters such as estimated glomerular filtration rate and protein-tocreatinine ratio were determined and correlated with imaging findings. Results: Success rates of tomoelastography, DWI, and BOLD imaging regarding both kidneys were 100%, 91%, and 87%, respectively. Shear wave speed was decreased in IgAN (−21%, P < 0.0001), accompanied by lower apparent diffusion coefficient values (−12%, P = 0.004). BOLD imaging was not sensitive to IgAN (P = 0.12). Tomoelastography detected IgAN with higher diagnostic accuracy than DWI (area under the curve = 0.9 vs 0.8) and positively correlated with estimated glomerular filtration rate (r = 0.66, P = 0.006). Conclusions: Chronic, advanced stage IgAN is associated with renal softening and restricted water diffusion. Tomoelastography is superior to DWI and BOLD imaging in detecting IgAN.

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confidence: 99%

Multiparametric Quantitative MRI for the Detection of IgA Nephropathy Using Tomoelastography, DWI, and BOLD Imaging

Lang¹,

Guo²,

Bruns³

et al. 2019

Invest Radiol

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“…In proliferative LN such as type III or type IV, lower renal tissue R2* values usually correspond with severe tubular damage. The inverse manifestation was observed in non-proliferative LN in which mild tubular injuries could be confirmed with renal biopsy samples [35]. Despite statistical discrepancy of R2* values detected between the two groups in both sharp uptrend and flat uptrend style data, the substantial R2* difference was very small.…”

Section: Discussionmentioning

confidence: 79%

Detection of Renal Hypoxia Configuration in Patients with Lupus Nephritis: A Primary Study Using Blood Oxygen Level‒Dependent MR Imaging

Zheng

Wang

Yan

et al. 2020

Preprint

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Background Renal microstructure and function are closely associated with homeostasis of oxygenation. Analyzing renal blood oxygen level‒dependent (BOLD) magnetic resonance imaging (MRI) examination results will provide information on the biological status of the kidneys. The current study was performed to explore the hypoxia mode of the entire renal parenchyma in patients with lupus nephritis (LN). Methods Twenty-three adult patients with LN and eighteen healthy volunteers were recruited. R2* values were acquired through the use of the BOLD MRI analysis technique. The narrow rectangular region of interest was used to explore the hypoxia configuration in entire depths of renal parenchyma. Acquired sequential R2* data were fitted by using four categories of mathematic functions. The tendency of R2* data in both patients with LN and healthy volunteers was also compared through the use of repeated-measures analysis of variance. Results R2* data from the superficial cortex to deep medulla displayed two patterns, called a sharp uptrend style and a flat uptrend style. After sequential R2* data were fitted individually with the use of four mathematic formulas, the multiple-compartment Gaussian function showed the highest goodness of fit. Compared with two categories of R2* value styles, the R2* tendency of entire parenchyma in patients with LN was different from that in healthy volunteers. Conclusions Deep renal medullary oxygenation was not always overtly lower than oxygenation in superficial renal cortical zone. Renal parenchyma oxygenation manifestation could be described through the use of a Gaussian function model. The deoxygenation tolerance capability was damaged in patients with LN.

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“…However, lower R2* values were also detected in control group (healthy volunteers group). [ 38 ]. Thirdly, we did not investigate other MRI index such as ADC, which was deemed to useful factor for prediction renal tissue fibrosis [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Blood oxygen level dependent magnetic resonance imaging for detecting pathological patterns in lupus nephritis patients: a preliminary study using a decision tree model

et al. 2018

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BackgroundPrecise renal histopathological diagnosis will guide therapy strategy in patients with lupus nephritis. Blood oxygen level dependent (BOLD) magnetic resonance imaging (MRI) has been applicable noninvasive technique in renal disease. This current study was performed to explore whether BOLD MRI could contribute to diagnose renal pathological pattern.MethodsAdult patients with lupus nephritis renal pathological diagnosis were recruited for this study. Renal biopsy tissues were assessed based on the lupus nephritis ISN/RPS 2003 classification. The Blood oxygen level dependent magnetic resonance imaging (BOLD-MRI) was used to obtain functional magnetic resonance parameter, R2* values. Several functions of R2* values were calculated and used to construct algorithmic models for renal pathological patterns. In addition, the algorithmic models were compared as to their diagnostic capability.ResultsBoth Histopathology and BOLD MRI were used to examine a total of twelve patients. Renal pathological patterns included five classes III (including 3 as class III + V) and seven classes IV (including 4 as class IV + V). Three algorithmic models, including decision tree, line discriminant, and logistic regression, were constructed to distinguish the renal pathological pattern of class III and class IV. The sensitivity of the decision tree model was better than that of the line discriminant model (71.87% vs 59.48%, P < 0.001) and inferior to that of the Logistic regression model (71.87% vs 78.71%, P < 0.001). The specificity of decision tree model was equivalent to that of the line discriminant model (63.87% vs 63.73%, P = 0.939) and higher than that of the logistic regression model (63.87% vs 38.0%, P < 0.001). The Area under the ROC curve (AUROCC) of the decision tree model was greater than that of the line discriminant model (0.765 vs 0.629, P < 0.001) and logistic regression model (0.765 vs 0.662, P < 0.001).ConclusionsBOLD MRI is a useful non-invasive imaging technique for the evaluation of lupus nephritis. Decision tree models constructed using functions of R2* values may facilitate the prediction of renal pathological patterns.Electronic supplementary materialThe online version of this article (doi: 10.1186/s12882-017-0787-z) contains supplementary material, which is available to authorized users.

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Detection of Renal Hypoxia in Lupus Nephritis Using Blood Oxygen Level-Dependent MR Imaging: A Multiple Correspondence Analysis

Cited by 16 publications

References 36 publications

Multiparametric Quantitative MRI for the Detection of IgA Nephropathy Using Tomoelastography, DWI, and BOLD Imaging

Multiparametric Quantitative MRI for the Detection of IgA Nephropathy Using Tomoelastography, DWI, and BOLD Imaging

Detection of Renal Hypoxia Configuration in Patients with Lupus Nephritis: A Primary Study Using Blood Oxygen Level‒Dependent MR Imaging

Blood oxygen level dependent magnetic resonance imaging for detecting pathological patterns in lupus nephritis patients: a preliminary study using a decision tree model

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