Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, PR China.
Department of Nephrology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, PR China.
Magn Reson Imaging. 2024 Feb;106:1-7. doi: 10.1016/j.mri.2023.07.002. Epub 2023 Jul 4.
To probe the correlations of parameters derived from standard DWI and its extending models including intravoxel incoherent motion (IVIM), diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DKI) with the pathological and functional alterations in CKD.
Seventy-nine CKD patients with renal biopsy and 10 volunteers were performed with DWI, IVIM, diffusion kurtosis tensor imaging (DKTI) scanning. Correlations between imaging results and the pathological damage [glomerulosclerosis index (GSI) and tubulointerstitial fibrosis index (TBI)], as well as eGFR, 24 h urinary protein and Scr) were evaluated.CKD patients were divided into 2 groups: group 1: both GSI and TBI scores <2 points (61 cases); group 2: both GSI and TBI scores ≥2 points (18 cases).
There were significant difference in cortical and medullary MD, and cortical D among 3 groups and between group 1 and 2. Cortical and medullary MD, cortical D, and medullary FA were negatively correlated with GSI score (r = -0.322 to -0.386, P < 0.05). Cortical and medullary MD and D, medullary FA were also negatively correlated with TBI score (r = -0.257 to -0.395, P < 0.05). These parameters were all correlated with eGFR and Scr. Cortical MD and D showed the highest AUC of 0.790 and 0.745 in discriminating mild and moderate-severe glomerulosclerosis and tubular interstitial fibrosis, respectively.
The corrected diffusion-related indices, including cortical and medullary D and MD, as well as medullary FA were superior to ADC, perfusion-related and kurtosis indices for evaluating the severity of renal pathology and function in CKD patients.
探讨标准 DWI 及其扩展模型（包括体素内不相干运动（IVIM）、扩散张量成像（DTI）和扩散峰度成像（DKI））的参数与 CKD 的病理和功能改变的相关性。
对 79 例接受肾活检的 CKD 患者和 10 名志愿者进行了 DWI、IVIM、扩散峰度张量成像（DKTI）扫描。评估影像学结果与病理损伤[肾小球硬化指数（GSI）和肾小管间质纤维化指数（TBI）]以及 eGFR、24 小时尿蛋白和 Scr 之间的相关性。将 CKD 患者分为 2 组：组 1：GSI 和 TBI 评分均<2 分（61 例）；组 2：GSI 和 TBI 评分均≥2 分（18 例）。
3 组间和组 1 与组 2 间皮质和髓质 MD 及皮质 D 存在显著差异。皮质和髓质 MD、皮质 D 及髓质 FA 与 GSI 评分呈负相关（r=-0.322 至-0.386，P<0.05）。皮质和髓质 MD 和 D、髓质 FA 也与 TBI 评分呈负相关（r=-0.257 至-0.395，P<0.05）。这些参数均与 eGFR 和 Scr 相关。皮质 MD 和 D 在鉴别轻度和中重度肾小球硬化和肾小管间质纤维化方面具有最高的 AUC（分别为 0.790 和 0.745）。
校正后的扩散相关指数，包括皮质和髓质 D 和 MD 以及髓质 FA，优于 ADC、灌注相关和峰度指数，可用于评估 CKD 患者肾脏病理和功能的严重程度。
