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Relationship of renal apparent diffusion coefficient and functional MR urography in children with pelvicalyceal

Maria A Bedoya1,2, Jeffrey I Berman3,4, Jorge Delgado3

  • 1Department of Radiology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA. bedoyam@email.chop.edu.

Pediatric Radiology
|April 20, 2019
PubMed

Insights

Renal apparent diffusion coefficient (ADC) in children with pelvicalyceal dilation does not correlate with functional or morphological changes seen on functional magnetic resonance urography (fMRU). This finding suggests ADC is not a reliable indicator for assessing ureteropelvic junction obstruction in this pediatric population.

Area of Science:

  • Pediatric Radiology
  • Renal Imaging
  • Diffusion-Weighted MRI

Background:

  • Pelvicalyceal dilation in children can indicate ureteropelvic junction obstruction.
  • Functional magnetic resonance urography (fMRU) assesses renal function and morphology.
  • Apparent diffusion coefficient (ADC) measures water molecule diffusion in tissues, potentially reflecting kidney health.

Purpose of the Study:

  • To evaluate age-related changes in renal ADC in children.
  • To assess the relationship between renal ADC and fMRU-derived parameters.
  • To determine if renal ADC can predict functional or morphological changes in pediatric kidneys with pelvicalyceal dilation.

Main Methods:

  • Retrospective analysis of fMRUs with diffusion-weighted imaging (DWI) in 70 pediatric kidneys.
  • Inclusion of kidneys with and without pelvicalyceal dilation, excluding duplex kidneys and ureteric dilation.
  • Measurement of ADC, calyceal and renal transit times (CTT, RTT), time-to-peak (TTP), and differential renal function (vDRF, pDRF, vpDRF).

Main Results:

  • Renal ADC showed an age-related increase in kidneys without pelvicalyceal dilation (R²=0.37).
  • No significant correlation was found between renal ADC and morphological parameters or fMRU functional metrics (P>0.07).
  • Median ADC values were similar in kidneys with and without pelvicalyceal dilation.

Conclusions:

  • Renal ADC does not correlate with fMRU findings in children with pelvicalyceal dilation.
  • ADC is not a reliable biomarker for assessing the severity of ureteropelvic junction obstruction based on fMRU parameters.
  • Further research may be needed to explore other applications of renal ADC in pediatric nephrology.
Abstract

Keywords:
Apparent diffusion coefficientChildrenDiffusion-weighted imagingDilationKidneyMagnetic resonance imagingUrography

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