Chronic kidney disease: pathological and functional assessment with diffusion tensor imaging at 3T MR

Area of Science:

• Medical Imaging
• Nephrology
• Biophysics

Background:

• Chronic kidney disease (CKD) impacts renal function and structure.
• Noninvasive imaging methods are crucial for assessing CKD progression and severity.

Purpose of the Study:

• To evaluate pathological and functional changes in CKD using 3 Tesla (3T) diffusion tensor imaging (DTI).
• To correlate DTI-derived metrics with estimated glomerular filtration rate (eGFR) and renal biopsy findings.

Main Methods:

• Fifty-one CKD patients and 19 healthy volunteers underwent 3T DTI scans.
• Mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured in the renal cortex and medulla.
• Correlations between DTI metrics, eGFR, and pathological damage (glomerular and tubulointerstitial injury) were analyzed.

Main Results:

• Renal cortical FA was lower than medullary FA in both healthy and CKD kidneys.
• Parenchymal FA was significantly lower in CKD patients compared to controls.
• FA and ADC positively correlated with eGFR, while FA negatively correlated with glomerular and tubulointerstitial injury scores.

Conclusions:

• DTI is a valuable noninvasive tool for assessing renal function and pathology in CKD patients.
• Decreased FA is indicative of glomerular lesions, tubulointerstitial injuries, and reduced eGFR in CKD.