Quantitative assessment of renal function and perfusion changes in membranous nephropathy using multiparametric...

Renal biopsy has certain limitations for diagnosing membranous nephropathy (MN). The aim is to explore the value of MRI for diagnosing MN.

MN patients were divided into two subgroups based on estimated glomerular filtration rate, including the mild group and moderate to severe group. Quantitative T1 mapping and renal blood flow (RBF) of bilateral kidneys were measured, including renal cortical T1 mapping (cT1) value, medullary T1 mapping (mT1) value, cortical RBF value (cRBF), and medullary RBF (mRBF) value. The Student's t-test, Mann-Whitney U test, chi-square test, and one-way analysis of variance were used.

Forty-seven MN patients and 54 matched healthy controls (HC) were prospectively enrolled. The cT1 and mT1 average values of HC were significantly lower than those of both MN subgroups (all p < 0.001) after adjusting for age and sex. Compared with the mild group and HC group, the moderate to severe group had lower cRBF (all p < 0.050) and mRBF average values (p = 0.012 and p < 0.001, respectively). The combination model of the T1 mapping and RBF values for differentiating MN from HC had a higher area under the curve of 0.87 (95% confidence intervals, 0.80-0.95) than single-parameter models (all p < 0.050), except the mT1 value model.

Multiparametric MRI shows potential as a noninvasive adjunct tool for assessing MN, offering a possibility to guide clinical decision-making.

Multiparametric MRI provides a noninvasive approach to renal structural and perfusion changes in membranous nephropathy and offers an alternative to guide clinical treatment strategies.

Renal biopsy has certain limitations for diagnosing membranous nephropathy, and there is an urgent need to develop a noninvasive method. Membranous nephropathy patients had higher cortex, medullary T1 mapping values and lower cortex, medullary renal blood flow values than healthy controls. Quantitative MRI parameters show potential as a noninvasive biomarker for assessing membranous nephropathy.