Zhang Ling, Ding Zhenshan, Pu Xiaoqi, Yue Xiuzheng, Li Yiwei, Zhuang Shangwen, Xie Sheng
Department of Radiology, China-Japan Friendship Hospital, Beijing, China.
Department of Urology, China-Japan Friendship Hospital, Beijing, China.
Quant Imaging Med Surg. 2025 May 1;15(5):4333-4342. doi: 10.21037/qims-24-2182. Epub 2025 Apr 22.
Multiparametric magnetic resonance imaging (mpMRI) has shown potential as a non-invasive tool for evaluating renal allografts. This study aimed to evaluate whether mpMRI could serve as a biomarker for predicting early renal allograft dysfunction.
A total of 31 patients (44.4±10.9 years, 6 females) who underwent mpMRI 1 month after kidney transplantation were included in the study. MpMRI parameters, including the apparent diffusion coefficient (ADC), renal blood flow (RBF), and T1-rho (T1ρ), were measured for all patients. The patients were divided into a stable group (SG) and an impaired group (IG) based on the increase in serum creatinine levels. The ADC, RBF, and T1ρ values were statistically compared between the two groups. Additionally, a receiver operating characteristic (ROC) curve analysis was used to assess the performance of the magnetic resonance imaging (MRI) parameters in predicting renal allograft dysfunction. Statistical analyses were performed using individual sample -tests, Chi-squared tests, logistic regression, ROC curves, and intraclass correlation coefficients (ICCs) to assess the data.
The SG comprised 20 patients and the IG comprised 11 patients. The baseline RBF and T1ρ differed significantly between the two groups (261.1±56.4 . 208.2±66.6 mL/100 g/min, P=0.04; 116.1±20.0 . 98.3±9.7 ms, P=0.01, respectively). The binary logistic regression indicated that the baseline RBF and T1ρ values were significantly correlated with renal function at 3 months after transplantation (P<0.05). The ROC curve analysis revealed areas under the curve (AUCs) of 0.739 for RBF and 0.845 for T1ρ in distinguishing between stable and impaired allograft function. The AUC for the combination of RBF and T1ρ was 0.927, indicating that this combination had the highest performance in predicting early renal allograft dysfunction.
This study shows that mpMRI parameters, particularly RBF and T1ρ mapping, have potential as biomarkers for predicting early renal allograft dysfunction.
多参数磁共振成像（mpMRI）已显示出作为评估肾移植的非侵入性工具的潜力。本研究旨在评估mpMRI是否可作为预测早期肾移植功能障碍的生物标志物。
本研究纳入了31例肾移植术后1个月接受mpMRI检查的患者（年龄44.4±10.9岁，女性6例）。对所有患者测量了mpMRI参数，包括表观扩散系数（ADC）、肾血流量（RBF）和T1-ρ（T1ρ）。根据血清肌酐水平的升高将患者分为稳定组（SG）和受损组（IG）。对两组之间的ADC、RBF和T1ρ值进行统计学比较。此外，采用受试者工作特征（ROC）曲线分析来评估磁共振成像（MRI）参数在预测肾移植功能障碍方面的性能。使用单样本检验、卡方检验、逻辑回归、ROC曲线和组内相关系数（ICC）进行统计分析以评估数据。
SG组包括20例患者，IG组包括11例患者。两组之间的基线RBF和T1ρ有显著差异（分别为261.1±56.4. 208.2±66.6 mL/100 g/min，P = 0.04；116.1±20.0. 98.3±9.7 ms，P = 0.01）。二元逻辑回归表明，基线RBF和T1ρ值与移植后3个月的肾功能显著相关（P<0.05）。ROC曲线分析显示，在区分稳定和受损的移植肾功能方面，RBF的曲线下面积（AUC）为0.739，T1ρ的AUC为0.845。RBF和T1ρ联合的AUC为0.927，表明该联合在预测早期肾移植功能障碍方面具有最高性能。
本研究表明，mpMRI参数，特别是RBF和T1ρ成像，有潜力作为预测早期肾移植功能障碍的生物标志物。
