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The value of intravoxel incoherent motion and arterial spin labeling MRI for evaluating early renal allograft function / 中华放射学杂志
Chinese Journal of Radiology ; (12): 357-363, 2019.
Article in Chinese | WPRIM | ID: wpr-754930
ABSTRACT
Objective To assess the value of diffusion and perfusion properties of early renal allografts with intravoxel incoherent motion (IVIM) and arterial spin labeling (ASL) MR imaging. Methods Seventy‐six renal allograft recipients were included from May 2014 to December 2015 in First Center Hospital of Tianjin in this prospective study. All subjects underwent conventional, IVIM and ASL MRI. Recipients were divided into 3 groups based on the estimated glomerular filtration rate (eGFR) and chronic kidney disease group 1, recipients with good allograft function (eGFR≥60 ml·min-1·1.73 m-2,n=44); group 2, recipients with mild to moderate impaired allograft function (30 ml·min-1·1.73 m-2≤eGFR<60 ml·min-1· 1.73 m-2,n=19); group 3, recipients with severe impaired allograft function (eGFR<30 ml·min-1·1.73 m-2, n=13). Apparent diffusion coefficient (ADC), pure diffusion coefficient (ADCslow), pseudo‐diffusion coefficient (ADCfast), perfusion fraction (PF), renal blood flow (RBF) in the cortex and medullar were measured. A paired t‐test was used to test the difference of cortical or medullary index values between the cortex and medulla in three groups. One‐way analysis of variance (ANOVA) and least significant difference (LSD) were used to test the difference of the index values among three groups. Pearson correlation coefficients were used to evaluate the correlation of all index values with eGFR. The receiver operating characteristic (ROC) curve was performed to assess the diagnostic efficacy of using IVIM and ASL index values to discriminate different renal functions. The ROC curve and binary logistic regression analyses were performed to assess the diagnostic efficacy of using IVIM and ASL alone or a combination of them to distinguish allografts with different renal functions. Results ADC, ADCslow, ADCfast values between cortex and medulla were significantly different in group 1 and 3, as well as PF in group 1 (P<0.05). ADC, ADCslow, ADCfast, PF, RBF in the cortex and ADC, PF in the medulla were significant different between group 2 and 1 (P<0.05);except PF in the medulla in group 3, other index values were significant different between group 3 and 2 (P<0.05).All index values exhibited a correlation with renal function as determined by eGFR for recipients(r were 0.603, 0.590,0.604,0.457,0.552,0.552,0.579,0.425,0.673 respectivily, P<0.01). ADC, ADCslow, ADCfast, PF, RBF in the cortex and ADC in the medulla showed a relatively high diagnostic efficacy to discriminate renal allografts with different functions. Cortical ADC showed a better diagnostic efficacy(Z=2.699,P=0.007) than cortical ADCslow when distinguishing group 1 from 2.The combination of IVIM and ASL MRI showed a better diagnostic efficacy to distinguish group 1 from 2 than IVIM and ASL MRI alone, with an AUC of 0.969, a sensitivity of 100.0% and a specificity of 93.2% (P<0.05). Conclusions IVIM and ASL MRI can evaluate the diffusion and perfusion properties of renal allografts. A combination of IVIM and ASL MRI can better distinguish different functional allografts.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Observational study / Prognostic study Language: Chinese Journal: Chinese Journal of Radiology Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Observational study / Prognostic study Language: Chinese Journal: Chinese Journal of Radiology Year: 2019 Type: Article