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Published on: April 7, 2015
Diffusion Tensor Imaging MRI With Spin-Echo Sequence and Long-Duration Measurement for Evaluation of Renal Fibrosis
J-Y Kaimori1, Y Isaka2, M Hatanaka2
1Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Suita, Japan; Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Background:
Renal fibrosis (RF) is a well-known marker for chronic kidney disease (CKD) progression, including chronic renal injury after renal transplantation. However, invasive biopsy is an available examination for evaluation of RF. Diffusion MRI was once recognized as a promising option for RF. However, it is now controversial for RF evaluation in a unilateral ureteral obstruction (UUO) model.
Methods:
To seek an optimal imaging method applicable for RF in UUO model kidneys, we attempted a series of MRI methods, including proton density-weighted imaging, T1-weighted imaging, T2-weighted imaging, T2*-weighted imaging, diffusion-weighted imaging, and diffusion tensor imaging (DTI).
Results:
We identified DTI MRI by spin-echo sequence plus a special kidney attachment as the best option for evaluation of renal UUO fibrosis, compared with normal kidney on the opposite side. To confirm these results, we applied this technique to a rat UUO therapeutic model with the anti-fibrotic reagent Fasudil. Fractional anisotropy values calculated from DTI MRI showed statistically significant linear correlation with the RF area measured by use of Sirius red or Masson trichrome staining of the positive area [cortex (r = 0.6397, P = .0283) and outer stripe of the outer medulla (r = 0.7810, P = .0039)].
Conclusions:
By use of the DTI MRI with spin-echo sequence, it may be possible to accurately evaluate RF in CKD.
Insights
Diffusion tensor imaging (DTI) MRI is an effective, non-invasive method for evaluating renal fibrosis (RF) in chronic kidney disease (CKD) models. This technique shows significant correlation with fibrosis extent, offering a promising alternative to invasive biopsies.
Area of Science:
- Nephrology
- Radiology
- Medical Imaging
Background:
- Renal fibrosis (RF) is a key indicator of chronic kidney disease (CKD) progression and post-transplant renal injury.
- Invasive renal biopsy is the standard for RF evaluation, but non-invasive methods are needed.
- Diffusion MRI shows potential for RF assessment but faces controversy in unilateral ureteral obstruction (UUO) models.
Purpose of the Study:
- To identify an optimal, non-invasive imaging method for evaluating renal fibrosis in UUO models.
- To compare various MRI techniques for their efficacy in detecting and quantifying renal fibrosis.
Main Methods:
- A series of MRI methods were evaluated, including proton density-weighted, T1-weighted, T2-weighted, T2*-weighted, diffusion-weighted imaging, and diffusion tensor imaging (DTI).
- DTI MRI with a spin-echo sequence and a specialized kidney attachment was identified as the most effective technique.
- The technique was validated in a rat UUO model treated with the anti-fibrotic agent Fasudil.
Main Results:
- DTI MRI with a spin-echo sequence proved superior for evaluating renal fibrosis in UUO kidneys compared to contralateral normal kidneys.
- Fractional anisotropy values from DTI MRI demonstrated a statistically significant linear correlation with the area of renal fibrosis.
- Correlation was observed in both the cortex (r=0.6397, P=.0283) and the outer stripe of the outer medulla (r=0.7810, P=.0039).
Conclusions:
- DTI MRI utilizing a spin-echo sequence offers an accurate, non-invasive method for evaluating renal fibrosis in CKD.
- This imaging approach may provide a valuable alternative to traditional biopsy methods for RF assessment.
