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Diffusion-weighted, intravoxel incoherent motion, and diffusion kurtosis tensor MR imaging in chronic kidney

Jie Zhu1, Aiqun Chen2, Jiayin Gao1

  • 1Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, PR China.

Magnetic Resonance Imaging
|July 6, 2023
PubMed
Abstract

Insights

Advanced diffusion MRI techniques, including diffusion kurtosis tensor imaging (DKTI), can effectively assess chronic kidney disease (CKD) severity. Key diffusion parameters correlate with kidney damage and function, outperforming standard metrics.

Area of Science:

  • Radiology and Imaging
  • Nephrology
  • Biomedical Engineering

Background:

  • Chronic kidney disease (CKD) involves progressive renal pathological and functional decline.
  • Standard imaging lacks sensitivity in quantifying CKD severity.
  • Advanced diffusion MRI models offer potential for non-invasive assessment.

Purpose of the Study:

  • To evaluate correlations between diffusion MRI parameters (DWI, IVIM, DTI, DKI) and CKD pathology/function.
  • To compare the efficacy of different diffusion models in assessing renal damage.

Main Methods:

  • Diffusion MRI including DWI, IVIM, and DKTI performed on 79 CKD patients and 10 controls.
  • Correlations analyzed between imaging parameters and renal biopsy scores (GSI, TBI), eGFR, and urinary protein.
  • Patients stratified into groups based on GSI and TBI scores.

Main Results:

  • Cortical and medullary diffusion parameters (D, MD) and medullary FA showed significant differences across CKD severity groups.
  • These parameters negatively correlated with GSI and TBI scores, indicating increased damage with lower diffusion values.
  • Cortical MD and D demonstrated high AUC for discriminating CKD severity.

Conclusions:

  • Corrected diffusion indices (cortical/medullary D and MD, medullary FA) are superior to ADC, perfusion, and kurtosis indices for evaluating CKD.
  • Diffusion MRI provides a sensitive, non-invasive tool for assessing renal pathology and function in CKD.
Keywords:
Chronic kidney diseaseDiffusion-weighted magnetic resonance imagingRenal pathology

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