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Performance of Intravoxel incoherent motion (IVIM) imaging in the curative effect evaluation of diabetic nephropathy - A preliminary studyJing Chen1, Xirong Zhang1, Nan Yu1, Qi Yang1, Yong Yu1, Robert Grimm2, and Shaoyu Wang3
1AFFILIATED HOSPITAL OF SHAANXI UNIVERSITY OF CHINESE MEDICINE, Xianyang, China, 2Siemens Healthcare, Erlangen, Germany, 3MR Scientific Marketing, Siemens Healthcare, Xi'an, Xi'an, China
Synopsis
Diabetes has nowadays become one of the major public health problems. Early detection and intervention is crucial to delay the progress of Diabetic kidney disease. In this study, IVIM imaging was used to evaluate the renal-cortex- and medulla-related parameter changes before and after the treatment of diabetic nephropathy. It was found that after treatment, D, f, D *and ADC values were increased, indicating the improved microvascular perfusion.
Introduction
Diabetes has nowadays become one of the major public health problems. Early detection and intervention is crucial to delay the progress of Diabetic kidney disease. In this study, we aimed to investigate the changes of IVIM parameters before and after clinical treatment of patients with diabetic nephropathy, and also evaluate the clinical therapeutic effects in patients.Methods
20 patients（mean age and standard deviation, 56.60±9.38）with diabetic nephropathy were enrolled in this study. 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 acquired on a 3T scanner (MAGNETOM Skyra, Siemens Healthcare, Erlangen, Germany) . A total of 12 regions of interest (ROIs) were manually drawn in the cortex and medulla region of the upper pole, the renal hilum, and the lower pole of the kidneys. Mean values of parametric maps were calculated for each ROI. Using the DWI data, apparent diffusion coefficient (ADC) maps were inline calculated with the Siemens MRWP workstation. IVIM parameters (ADC, D, f, and D* values) were generated using a prototype software, body diffusion toolbox (Siemens Healthcare, Erlangen, Germany). Paired-sample t-test was used to compare the parametric changes of ADC, D, f, and D* values in renal cortex and medulla before and after treatment in patients with diabetic nephropathy.Results
The clinical symptoms of diabetic nephropathy patients were improved after clinical evaluation. Compared to pre-treatment, ADC, D, f, and D* values of both kidney and medulla in patients with diabetic nephropathy were significantly increased (p < 0.001) (Figure 1, Table 1).Discussion & Conclusion
After treatment, it was found that the IVIM parameters, D, f, D* and ADC, in diabetic nephropathy patients were significantly increased, suggesting that the microvascular perfusion of diabetic nephropathy patients was improved. The findings in this study indicate that IVIM is feasible for the evaluation as well as monitoring of the efficacy of diabetic nephropathy. Being sensitive to the functional changes in the renal microstructures, IVIM could deliver potential clinical significance for the objective assessment of clinical efficacy in diabetic nephropathy.Acknowledgements
No acknowledgement found.References
No reference found.Figures
Table1：The D,D*,f,ADC,and t,p values before treatment and after treatment for Diabetic nephropathy patients
Figure 1: (A) and (B) show D and f parameter maps before treatment in Diabetic nephropathy; (C) and (D) show D and f parameter maps after treatment in Diabetic nephropathy. Multiple ROIs were placed in the double renal medulla, and the mean values were extracted for further analysis.