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Intravoxel incoherent motion (IVIM) diffusion weighted imaging in Renal Function Assessment of Diabetic Nephropathy – A Preliminary Study1AFFILIATED HOSPITAL OF SHAANXI UNIVERSITY OF CHINESE MEDICINE, Xianyang, China, 2Siemens Healthcare, Erlangen, Germany, 3MR Scientific Marketing, Siemens Healthcare, Xi'an, Xi'an, China
Synopsis
The aim of this study is to evaluate the renal microstructural changes in patients with diabetic nephropathy using intravoxel incoherent motion (IVIM) imaging. IVIM could be used to indicate the changes of renal function of diabetic nephropathy patients, especially in renal cortex. The changes of renal function were found to be positively correlated with the glomerular filtration rate. Thus IVIM could deliver useful information for the early diagnosis of diabetic nephropathy.
Introduction
Diabetic nephropathy is one of the most severe microvascular complications of diabetes involving the kidneys and is the leading cause of end-stage renal diseases. To understand the mechanism of diabetic nephropathy is critical for the diagnosis and treatment of diabetes. As intravoxel incoherent motion (IVIM) could be used to indicate the changes of renal function of diabetic nephropathy patients, especially in renal cortex, the aim of this study is to evaluate the renal microstructural changes in patients with diabetic nephropathy using IVIM imaging.
Methods
20 patients (mean age and standard deviation (SD), 56.60±9.38) with clinically diagnosed diabetic nephropathy were enrolled in the observation group, and 20 healthy volunteers（mean age and SD, 57.60±6.08）were recruited in the control group. For all diabetic nephropathy patients, glomerular filtration rate (eGFR) was diagnosed in laboratory tests.The IVIM (b=0,50,100,150,200,400,600,800 sec/mm²) and diffusion weighted imaging (DWI, b=50,800 sec/mm²) sequences were obtained on a 3T scanner (MAGNETOM Skyra, Siemens Healthcare, Erlangen, Germany). A total of 12 regions of interest (ROI) were manually drawn for each subject in the cortex and medulla region of the upper pole, the renal hilum and the lower pole of the kidneys, and mean parametric values were calculated for each ROI. The apparent diffusion coefficients (ADC) maps from DWI acquisition were automatically calculated in the Siemens MRWP workstation. IVIM parameters (ADC, D, f and D* values) were calculated using a prototype software, body diffusion toolbox (Siemens Healthcare, Erlangen, Germany). A two-sample t-test was used to compare the mean values of ADC, D, f, and D* values between the observation and control groups. Pearson correlation analysis was performed to determine the relationship between the ADC, D, f, and D* values and eGFR in patients with diabetic nephropathy.Results
In the two groups, the ADC, D, f, and D* values of the renal cortex were significantly higher than those in medulla. Compared to control group, the ADC, D, F, and D* values of the renal cortex and medulla in the observation group were significantly reduced (p<0.0001) (Figure 1,Table 1). ADC,D,F and D* values in patients with diabetic nephropathy were positively correlated with eGFR (p<0.001) (Figure 2).Discussion & Conclusion
IVIM is feasible in the examination of diabetic nephropathy. IVIM could deliver useful information for the detection of kidney damages in diabetic nephropathy. Combined with the eGFR, the progress of diabetic nephropathy can be monitored. By reflection the microstructural changes, IVIM might be helpful in the evaluation of renal functions in diabetic nephropathy.Acknowledgements
No acknowledgement found.References
No reference found.Figures
