Exploration of Interstitial Fibrosis in Chronic Kidney Disease by Diffusion‐Relaxation Correlation Spectrum MR Imaging: A Preliminary Study
Background Renal interstitial fibrosis is one of the most common pathways in the progression of chronic kidney disease (CKD). Noninvasive evaluation of interstitial fibrosis would help monitoring CKD progression and prognosis prediction. Purpose To evaluate the severity of renal interstitial fibrosi...
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Published in | Journal of magnetic resonance imaging Vol. 58; no. 2; pp. 415 - 426 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Hoboken, USA
John Wiley & Sons, Inc
01.08.2023
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Background
Renal interstitial fibrosis is one of the most common pathways in the progression of chronic kidney disease (CKD). Noninvasive evaluation of interstitial fibrosis would help monitoring CKD progression and prognosis prediction.
Purpose
To evaluate the severity of renal interstitial fibrosis by diffusion‐relaxation correlation spectrum imaging (DR‐CSI).
Study Type
Prospective.
Subjects
Forty patients with CKD and 10 healthy controls (average age 49.2 ± 14.8 years, 18 females).
Field Strength/Sequence
3‐T, DR‐CSI with 36 axial spin‐echo echo‐planar diffusion‐weighted images (6 b‐values, 6 echo times).
Assessment
Interstitial fibrosis level (IFL) was assessed from biopsy results (IFL = 1, fibrosis percentage <25%, defined as mild; IFL = 2, 25%–50%, moderate; IFL = 3, >50%, severe). Estimated glomerular filtration rate (eGFR) was calculated using serum creatinine. The regions of interest included cortex for both kidneys. The diffusivity‐T2 spectrum was assessed considering three compartments (threshold: T2 30–40 msec, diffusivity 5–9 μm2/msec, according to visible peaks): A (low diffusivity, short T2), B (low diffusivity, long T2), and C (high diffusivity). Volume fractions Vi (i = A, B, C) were calculated.
Statistical Tests
Intra‐class coefficient (ICC, >0.6 as good) to assess inter‐reader agreement of DR‐CSI Vi. Spearman's correlation to assess relationship of Vi to IFL and eGFR. Receiver operating characteristic analyses with the area under the curve (AUC) to discriminate patients with moderate‐severe fibrosis from mild ones. Statistical significance criteria: P‐value <0.05.
Results
ICCs were good for all Vi. Correlations were found between IFL and VB (r = 0.424, significant) and VC (r = −0.400, significant), and between eGFR and VB (r = −0.303, P = 0.058) and VC (r = 0.487, significant). Regarding VB and VC, the AUCs were 0.903 and 0.824.
Data Conclusion
DR‐CSI help distinguish patients with moderate or severe renal interstitial fibrosis from mild ones.
Evidence Level: 2
Technical Efficacy: Stage 2 |
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Bibliography: | Fang Liu and Wentao Hu have contributed equally to this work. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1053-1807 1522-2586 |
DOI: | 10.1002/jmri.28535 |