Renal function impairment in liver cirrhosis: preliminary results with diffusion-weighted imaging at 3 T

The purpose of this study was to investigate the utility of diffusion-weighted MRI (DWI) at 3 T for assessing renal function impairment in patients with liver cirrhosis.

Sixty-four patients with liver cirrhosis who underwent both DWI at 3 T and renal function testing were retrospectively included. Twenty-two patients had moderate or severe renal function impairment (group A, estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m(2)) and 42 had good renal function or mild renal function impairment (group B, eGFR ≥ 60 mL/min/1.73 m(2)). Cortical and medullary apparent diffusion coefficients (ADCs) of both kidneys were measured. AUC was assessed for predicting group A with ADC. The correlation between renal ADC and eGFR or serum creatinine was analyzed. The reproducibility of ADC measurement was investigated.

Both cortical and medullary ADCs were lower in group A than in group B, (both, p < 0.05). In all patients, AUCs were 0.784 and 0.737 with cortical and medullary ADCs, respectively, for predicting group A. Both cortical and medullary ADCs had linear correlation with eGFR or serum creatinine (both, p < 0.05). The reproducibility of measurement was excellent for cortex (intraclass coefficient [ICC] = 0.808) and good for medulla (ICC = 0.692), with 1.6% or less variability.

DWI may have potential for assessing renal function impairment in patients with liver cirrhosis.