Intravoxel incoherent motion imaging of the kidney: The application in patients with hyperuricemia

Abstract

Background Hyperuricemia is an independent risk factor for onset and progression of kidney disease. However, there remains a lack of a reliable and noninvasive biomarker to identify and monitor the changes of renal function in patients with hyperuricemia. Purpose To assess the utility of intravoxel incoherent motion (IVIM) parameters in identifying the early changes of renal function in patients with hyperuricemia. Study Type Retrospective case–control study. Population Eighty‐four male participants, including asymptomatic hyperuricemia (AH, 27 cases), gouty arthritis (GA, 31 cases), and 26 age‐matched healthy controls. Field Strength/Sequence 3.0T; intravoxel incoherent motion (IVIM). Assessment Differences in the IVIM parameters among the three groups were assessed. Pure molecular diffusion (D value); perfusion‐related diffusion (D* value); pseudodiffusion fraction (f value); apparent diffusion coefficient (ADC value); estimated glomerular filtration rate (eGFR). Also, they were correlated with eGFR. Statistical Tests Bonferroni test, Tamhane's T2 method, and Pearson correlation analysis. Results The D values in renal cortex and medulla significantly decreased from the control, AH to GA groups (P < 0.05). The GA patients had a significantly lower cortical f value than the controls and AH patients (P < 0.05). The medullary f values in the AH and GA patients were significantly lower than that in the controls (P < 0.05). Also, the cortical and medullary ADC values had similar results across the three groups (P < 0.05), except for the comparison between the AH and GA groups (P = 0.668, P = 0.111, respectively). No significant correlation was found between any IVIM parameters with eGFR. Data Conclusion IVIM imaging may be helpful for detecting the early changes of renal function induced by hyperuricemia. The D value could be the most sensitive IVIM‐derived parameter in the assessment of renal function in patients with hyperuricemia in this study. Level of Evidence: 3 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2020;51:833–840.

Multiparametric MRI analysis for the evaluation of renal function in patients with hyperuricemia: a preliminary study

“…These parameters are all quantitative indexes of water molecule diffusion, and their common changing trends could prove each other although there are some subtle differences among them. As mentioned in our previous studies [ 12 ], an elevation in the serum urate concentration could trigger an inflammatory response, resulting in inflammatory cell proliferation and infiltration in renal parenchyma. Also, it could stimulate vascular smooth muscle cell proliferation and cause the deposition of urate crystal.…”

“…Intravoxel incoherent motion imaging (IVIM), diffusion tensor imaging (DTI), and blood-oxygen-level-dependent (BOLD) techniques are the most common fMRI tools in assessing the renal function from the hemodynamics (diffusion and perfusion), microstructure (diffusion and directivity of diffusion), and oxygenation perspectives, respectively [ 10 ]. Our team has applied the IVIM technique to predict renal dysfunction at the early stage of diabetic nephropathy [ 11 ] and hyperuricemia [ 12 ]. We found that IVIM parameters might be a sensitive predictor of early diabetic and hyperuricemic nephropathies.…”

Intravoxel Incoherent Motion Quantification Dependent on Measurement SNR and Tissue Perfusion: A Simulation Study

“…IVIM imaging is very powerful because it not only provides the information of classic diffusion imaging accurately, but also extracts information about perfusion imaging. Several clinical and simulation studies have shown that IVIM imaging is a promising technique to diagnose abnormalities in brain, liver, kidney, breast, and prostate [5][6][7][8][9][10]. There is no need for exogenous contrast agent injection to extract IVIM perfusion information, which is the main limitation of classical perfusion MRI.…”

The Rho kinase signaling pathway participates in tubular mitochondrial oxidative injury and apoptosis in uric acid nephropathy

“…CKD is defined as the presence of renal damage or renal dysfunction for more than 3 months, 3 and evidence showed that hyperuricemia is associated with renal tubular epithelial cell injury, which increases the risk of CKD. 4 – 6 Studies showed that hyperuricemia impaired renal function occurs via obstruction of renal tubules by urate crystal deposition, which results in renal tubular cell injury and subsequent renal interstitial fibrosis. 7 , 8 Therefore, early stage intervention measures for hyperuricemia nephropathy (HN) are of great importance to reduce the socioeconomic burden of CKD.…”