Based on functional and histopathological correlations: Is diffusion kurtosis imaging valuable as a noninvasive assessment of renal damage in early stage of chronic kidney disease?


Youjun Cao*, Jiazhen Lin, Feng Cui, Hua Qu, Yongsheng Zhang, Xianjie Le and Jiazhen Yin

Purpose: To evaluate the potential of 3T magnetic resonance Diffusion Kurtosis Imaging (DKI) in assessing the renal damage in early stage of Chronic Kidney Disease (CKD) patients with normal or slightly changed functional index, using histopathology as reference standard.

Methods: 49 CKD patients and 18 healthy volunteers were recruited in this study. CKD patients were divided into two groups based on estimated Glomerular Filtration Rate (eGFR): Study group I ((CKD stage 1) eGFR ≥ 90 ml/min/1.73 m2 (n=20)) and Study group II (eGFR<90 ml/min/1.73 m2 (n=29)). DKI was performed in all participants and the DKI parameters Mean Kurtosis (MK), Mean Diffusivity (MD), Fractional Anisotropy (FA) of renal cortex and medulla were measured. The differences of parenchymal MD, MK and FA values among the different groups were compared. The correlations between DKI parameters and clinicopathological characteristics were assessed. Diagnostic performance of DKI to assess renal damage in early stage of CKD was analyzed.

Results: The cortical MD and MK values showed significant difference among three groups (P<0.05): Trend of cortical MD values: Study group II2.

Conclusion: DKI shows potential in non-invasive and multi parameter quantitative assessment of renal damage in early stage of CKD patients and provide additional information for changes in renal function and histopathology when CKD progressed.

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