Multiparametric MRI for Early Chronic Kidney Disease Detection: Insights Into Renal Microcirculation

Area of Science:

• Nephrology
• Radiology
• Medical Imaging

Background:

• Chronic kidney disease (CKD) represents a significant global health challenge.
• Impaired intrarenal microcirculation is an early indicator of CKD, often preceding functional decline.
• Noninvasive methods are needed to characterize microcirculatory changes and enable early detection.

Purpose of the Study:

• To evaluate the utility of contrast-free multiparametric MRI (mp-MRI) in characterizing intrarenal microcirculation.
• To determine if mp-MRI can improve the early detection of CKD.
• To correlate MRI findings with histopathological severity of CKD.

Main Methods:

• Retrospective study involving 54 CKD patients and 20 healthy controls (HCs).
• mp-MRI protocol included arterial spin labeling (ASL), intravoxel incoherent motion imaging (IVIM), blood oxygen level-dependent (BOLD) imaging, and quantitative susceptibility mapping (QSM).
• Renal biopsy served as the reference standard; logistic regression models were used for discrimination.

Main Results:

• Significant differences in renal blood flow, diffusion (D, D*, f), R2*, and susceptibility values were observed between CKD patients and HCs.
• All MRI parameters and clinical biomarkers correlated with histopathological severity.
• An mp-MRI model achieved excellent discrimination for CKD versus HCs (AUC=0.976) and mild CKD versus HCs (AUC=0.948).

Conclusions:

• Contrast-free mp-MRI can effectively characterize intrarenal microcirculation alterations in CKD.
• This imaging framework demonstrates high diagnostic performance for early CKD detection.
• mp-MRI offers a promising noninvasive tool for assessing renal microcirculation and aiding early CKD diagnosis.