Diffusion-weighted MR imaging of kidneys in patients with chronic kidney disease: initial study

Xu, Xueqin; Fang, Wenqiang; Ling, Huawei; Chai, Weimin; Chen, Kemin

doi:10.1007/s00330-009-1619-8

Cited by 107 publications

(92 citation statements)

References 16 publications

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“…Quantitative diffusion-weighted magnetic resonance imaging (MRI) may offer this opportunity and can play a role in the evaluation of renal disease. Several studies have indicated the potential use of the apparent diffusion coefficient (ADC) as a marker of renal function, showing lower renal ADC in kidney dysfunction (4)(5)(6)(7)(8)(9). Yet, there are only a few studies concerning the use of renal quantitative diffusion-weighted imaging (DWI) in diabetic nephropathy (5, 9-11).…”

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confidence: 99%

Renal diffusion-weighted imaging in diabetic nephropathy: correlation with clinical stages of disease

Çakmak¹,

Yağcı²,

Dursun³

et al. 2014

Diagn Interv Radiol

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Original Article PURPOSE We aimed to assess the correlation between renal apparent diffusion coefficient (ADC) values measured by diffusion-weighted imaging (DWI) and the clinical stages of diabetic nephropathy. MATERIALS AND METHODS DWI (b value, 0 and 600 s/mm2 ) was performed in 78 patients with clinically confirmed diabetic nephropathy (study group) and 22 volunteers without diabetes mellitus or any renal disease (control group). The mean ADCs were calculated from multiple region-of-interest circles positioned in the renal cortex. Diabetic nephropathy was clinically categorized into five stages based on the values of urinary albumin excretion and glomerular filtration rate (GFR). RESULTSMean renal ADC values of patients with stage 3 or 4 disease were significantly lower than those in patients with stage 1 or 2 disease and the control group (P < 0.001). ADC values of patients with stage 5 disease were significantly lower than those in patients with stage 4 (P = 0.003), stage 3 (P = 0.020), stages 2 and 1, and the control group (P < 0.001). Significant correlations were found between mean renal ADC values and clinical stages of diabetic nephropathy (r=−0.751, P < 0.001), between mean renal ADC values and estimated GFR values (r=0.642, P < 0.001), and between mean renal ADC values and urinary albumin excretion (r=−0.419, P < 0.001). CONCLUSIONRenal ADC values show a significant correlation with clinical stages of diabetic nephropathy. As a relatively simple and noninvasive tool without contrast media administration, renal quantitative DWI may potentially play a role in making clinical decisions in the follow-up of diabetic patients. Diabetic nephropathy is classically defined as a clinical syndrome characterized by persistent albuminuria, a relentless decline in glomerular filtration rate (GFR) progressing to end-stage renal disease, raised arterial blood pressure, and enhanced cardiovascular morbidity and mortality (1). In diabetic patients, renal functional deterioration is the result of heterogeneous renal structural changes, including glomerular basal membrane thickening and mesangial expansion, extracellular matrix accumulation, mesangiolysis, reduced podocyte number, microaneurysm formation, arteriolar hyalinosis which ultimately leads to glomerulosclerosis, tubular atrophy, interstitial expansion, and fibrosis (2). Renal damage occurs in multiple stages. Throughout its early stages, diabetic nephropathy has no symptoms. Persistent microalbuminuria is a predictor of the development of clinical nephropathy. Microalbuminuria has been proposed as a marker of widespread endothelial dysfunction and indicates microvascular damage (3). Better understanding of the mechanisms that lead to structural and functional changes in the diabetic kidney may facilitate the development of more effective follow-up and treatment modalities. Diagnostic tests that help identify early microvascular damage at an early stage will provide significant benefits to get the disease under control. Quantitative diffusion-weighted magnetic...

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mentioning

confidence: 99%

Renal diffusion-weighted imaging in diabetic nephropathy: correlation with clinical stages of disease

Çakmak¹,

Yağcı²,

Dursun³

et al. 2014

Diagn Interv Radiol

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“…Moreover, the water diffusion between intra and extra-cellular can be estimated by the apparent diffusion coefficient (ADC) (11). In renal parenchyma, the value of ADC mainly depends on the intra-and extra-cellular components fraction, ambient temperature, membrane permeability and capillary perfusion (12)(13)(14). Thus, DW-MRI can quantify alterations in water content as well as water exchange rate between intra and extra-cellular aspects of the kidney.…”

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confidence: 99%

Time course study on the effects of iodinated contrast medium on intrarenal water transport function using diffusion‐weighted MRI

Wang

Zhang

Yang

et al. 2012

Magnetic Resonance Imaging

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Purpose: To assess the effects of intravenous-injected iodinated contrast medium (CM) on intrarenal water diffusion using noninvasive diffusion-weighted MRI (DW-MRI). Materials and Methods:Ten New Zealand White rabbits were randomized to receive a 6 mL/kg body weight intravenous injection of clinically used iopamidol-370 (n ¼ 7) or an equivalent amount of 0.9% physiological saline (n ¼ 3). A sequential DW-MRI was performed to estimate the intrarenal apparent diffusion coefficient (ADC) at 24 h before and 1 h, 24 h, 48 h, and 72 h after administration.Results: Iopamidol produced a progressive ADC reduction in inner stripes of the renal outer medulla (IS) by 13.92% (P ¼ 0.05) at 1 h, 17.52% (P ¼ 0.02) at 24 h, 20.23% (P ¼ 0.01) at 48 h and 16.31% (P ¼ 0.04) at 72 h after injection. Cortical ADC was decreased by 14.14% (P ¼ 0.01) at 48 h and 14.12% (P ¼ 0.01) at 72 h after injection. Iopamidol produced slight decrease of ADCs in outer stripes of the outer medulla (OS) and inner medulla (IM) of kidney but without statistical difference. In control group, no significant ADC changes was observed in each anatomic compartment due to saline injection (P > 0.05). Conclusion:As demonstrated by DW-MRI, intravenous iopamidol injection resulted in a successive reduction of intrarenal water diffusion, particularly in IS of kidney. This MR technique may be used as a noninvasive tool to perform a time course study of the pathogenesis associated with contrast-induced nephropathy (CIN).

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“…Considerable attention has been made to investigate the renal DWI across the world (4-6), and some recent studies had demonstrated that the DWI has potential clinical value in evaluating some renal diseases (7-10), such as renal artery stenosis, diffuse renal disease, renal tumor and renal infection (11)(12)(13)(14)(15), etc. However, as a novel functional imaging for the investigation of renal function, the DWI is mainly applied in adult patients and the studies focusing on renal diffusion of infants is scarce, and no study at present was found with regard to using renal ADC values to explore the hydronephrotic kidney in single children population.…”

Section: Discussionmentioning

confidence: 99%

“…As such, it would be difficult to exactly differentiate renal cortex and medulla in that situation and the measurement error will certainly increase when the ROIs are placed onto the cortex and medulla respectively. In addition, Xu et al (11) reported no significant signal difference was found between the renal cortex and medulla in DWI. Therefore, the approach of placing the ROI on specific plane was adopted in this study to measure the ADCs of local renal parenchyma.…”

Section: The Change Pattern Of Adc Values In Hydronephrotic Kidneys Amentioning

confidence: 95%

Relationship between renal apparent diffusion coefficient values and glomerular filtration rate in infants with congenital hydronephrosis

Lin

Gan

et al. 2014

BST

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Diffusion-weighted MR imaging of kidneys in patients with chronic kidney disease: initial study

Abstract: Diffusion-weighted MR imaging is feasible in the assessment of renal function, especially in the detection of early stage renal failure of CKD.

Cited by 107 publications

References 16 publications

Renal diffusion-weighted imaging in diabetic nephropathy: correlation with clinical stages of disease

Renal diffusion-weighted imaging in diabetic nephropathy: correlation with clinical stages of disease

Time course study on the effects of iodinated contrast medium on intrarenal water transport function using diffusion‐weighted MRI

Relationship between renal apparent diffusion coefficient values and glomerular filtration rate in infants with congenital hydronephrosis

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