Renal fat fraction and diffusion tensor imaging in patients with early-stage diabetic nephropathy

• Published in: European radiology Vol. 28; no. 8; pp. 3326 - 3334
• Main Authors: Wang, Yuan-Cheng, Feng, Yinglian, Lu, Chun-Qiang, Ju, Shenghong
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2018; Springer Nature B.V
• Subjects: Abnormalities; Adipose Tissue - pathology; Aged; Analysis of Variance; Anisotropy; Body Water; Deposition; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - pathology; Diabetic Nephropathies - pathology; Diabetic nephropathy; Diagnostic Radiology; Diffusion coefficient; Diffusion Tensor Imaging - methods; Female; Humans; Imaging; Internal Medicine; Interventional Radiology; Kidney - pathology; Kidney Medulla - pathology; Kidneys; Magnetic Resonance; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Molecular diffusion; Nephropathy; Neuroradiology; Observational studies; Patients; Prospective Studies; Radiology; Renal function; Renal Insufficiency - pathology; Ultrasound; Variance analysis; Observational study; Adipose tissue; Magnetic resonance imaging; Diabetic nephropathies; Diffusion tensor imaging
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-017-5298-6

Objective To investigate the renal fat fraction and water molecular diffusion features in patients with early-stage DN using Dixon imaging and diffusion tensor imaging (DTI). Methods Sixty-one type 2 diabetics (normoalbuminuria: n = 40; microalbuminuria: n = 21) and 34 non-diabetic volunteers were included. All participants received three-point Dixon imaging and DTI using a 3.0-T magnetic resonance imager. The fat fraction [FF] and DTI features [fractional anisotropy (FA), apparent diffusion coefficient (ADC), tract counts and length from DTI tractography] were collected. All image features were compared between cohorts using one-way ANOVA with Bonferroni post-hoc analysis. Results Renal FF in the microalbuminuric group was significantly higher than in the normoalbuminuric and control groups (5.6% ± 1.3%, 4.7% ± 1.1% and 4.3% ± 0.5%, respectively; p < 0.001). Medullary FA in the microalbuminuric group was the lowest (0.31 ± 0.06) in all cohorts. The tract counts and length in the renal medulla were significantly lower in the microalbuminuric group than in the other two groups. Conclusions Dixon imaging and DTI are able to detect renal lipid deposition and water molecule diffusion abnormalities in patients with early-stage DN. Both techniques have the potential to noninvasively evaluate early renal impairment in type 2 diabetes. Key points • Dixon imaging demonstrated renal fat deposition in early-stage DN; • Renal fractional anisotropy decreased in patients with early-stage DN; • Renal tractography demonstrated reduced track counts and length in early-stage DN.