Assessment of renal allograft function early after transplantation with isotropic resolution diffusion tensor imaging

Wang, Fan; Ren, Tong; Li, Qiong; Zuo, Panli; Long, Miaomiao; Mo, Chunbai; Chen, Lihua; Lixiang, Huang; Shen, Wen

doi:10.1007/s00330-015-3841-x

Cited by 46 publications

(28 citation statements)

References 32 publications

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“…The FA of the medulla exhibited a high correlation with eGFR, while that of the cortex did not. In a more recent study conducted by Fan et al [16] , similar results were reported, and the FA of the medulla was proposed as a valuable indicator of allograft function. These data indicated that the results of DTI were generally concordant with DWI, while DTI might offer additional information on the differences between the renal medulla and cortex caused by anisotropy.…”

Section: Wang Yt Et Al Functional Mri Of Transplanted Kidneyssupporting

confidence: 62%

Functional assessment of transplanted kidneys with magnetic resonance imaging

Wang

Yin

et al. 2015

WJR

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Kidney transplantation has emerged as the treatment of choice for many patients with end-stage renal disease, which is a significant cause of morbidity and mortality. Given the shortage of clinically available donor kidneys and the significant incidence of allograft dysfunction, a noninvasive and accurate assessment of the allograft renal function is critical for postoperative management. Prompt diagnosis of graft dysfunction facilitates clinical intervention of kidneys with salvageable function. New advances in magnetic resonance imaging (MRI) technology have enabled the calculation of various renal parameters that were previously not feasible to measure noninvasively. Diffusion-weighted imaging provides information on renal diffusion and perfusion simultaneously, with quantification by the apparent diffusion coefficient, the decrease of which reflects renal function impairment. Diffusion-tensor imaging accounts for the directionality of molecular motion and measures fractional anisotropy of the kidneys. Blood oxygen level-dependent MR evaluates intrarenal oxygen bioavailability, generating the parameter of R2* (reflecting the concentration of deoxyhemoglobin). A decrease in R2* could happen during acute rejection. MR nephro-urography/renography demonstrates structural data depicting urinary tract obstructions and functional data regarding the glomerular filtration and blood flow. MR angiography details the transplant vasculature and is particularly suitable for detecting vascular complications, with good correlation with digital subtraction angiography. Other functional MRI technologies, such as arterial spin labeling and MR spectroscopy, are showing additional promise. This review highlights MRI as a comprehensive modality to diagnose a variety of etiologies of graft dysfunction, including prerenal (e.g. , renal vasculature), renal (intrinsic causes) and postrenal (e.g. , obstruction of the collecting system) etiologies.

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Section: Wang Yt Et Al Functional Mri Of Transplanted Kidneyssupporting

confidence: 62%

Functional assessment of transplanted kidneys with magnetic resonance imaging

Wang

Yin

et al. 2015

WJR

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“…Several studies from the research group of Hueper et al, using a kidney transplantation animal model, have shown promising results for the use of MR after transplantation [16][17][18][19]. This same research group and several others have initiated studies to translate these outcomes to the clinical setting, showing significant associations between renal allograft function and several MRI sequences in small and heterogeneous cohorts [20][21][22][23][24]. These outcomes have not yet been validated in a larger and more homogenous population of renal transplant recipients and have therefore not yet been introduced to clinical protocols for post-transplant follow-up.…”

Section: Lessons Learntmentioning

confidence: 99%

Have we forgotten imaging prior to and after kidney transplantation?

et al. 2018

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“…Applying a diffusion weighting (indicated by the b-value) causes loss of signal which is proportional to the ADC and can be modeled using a mono-exponential function. Seven studies investigated mono-exponential DWI in kidney transplantation patients (Table 4) (Thoeny et al, 2006; Blondin et al, 2011; Hueper et al, 2011, 2016; Lanzman et al, 2013; Park et al, 2014; Fan et al, 2016) Next to the microscopic diffusion of water the signal measured in DWI is also sensitive to the microcirculation. As such, the measured ADC using low b-values reflects both diffusion and perfusion and the signal can be better described using a bi-exponential model that accounts for contribution of both compartments, which is also known as Intravoxel incoherent motion (IVIM) imaging.…”

Section: Clinical Experience With Functional Mri In Kidney Allograftsmentioning

confidence: 99%

“…Fan et al used DTI to study kidney allograft function early after transplantation and found significant differences between medullary and cortical FA in all subjects: healthy volunteers, and allograft recipients with good, moderate, and severely impaired function (Fan et al, 2016). Medullary FA was larger than cortical FA, probably reflecting the highly organized radial structure of the tubular system, clearly visible in Figure 4, in contrast to the mesh of small vessels and glomeruli found in the cortex (Fan et al, 2016).…”

Section: Clinical Experience With Functional Mri In Kidney Allograftsmentioning

confidence: 99%

Innovative Perspective: Gadolinium-Free Magnetic Resonance Imaging in Long-Term Follow-Up after Kidney Transplantation

et al. 2017

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Since the mid-1980s magnetic resonance imaging (MRI) has been investigated as a non- or minimally invasive tool to probe kidney allograft function. Despite this long-standing interest, MRI still plays a subordinate role in daily practice of transplantation nephrology. With the introduction of new functional MRI techniques, administration of exogenous gadolinium-based contrast agents has often become unnecessary and true non-invasive assessment of allograft function has become possible. This raises the question why application of MRI in the follow-up of kidney transplantation remains restricted, despite promising results. Current literature on kidney allograft MRI is mainly focused on assessment of (sub) acute kidney injury after transplantation. The aim of this review is to survey whether MRI can provide valuable diagnostic information beyond 1 year after kidney transplantation from a mechanistic point of view. The driving force behind chronic allograft nephropathy is believed to be chronic hypoxia. Based on this, techniques that visualize kidney perfusion and oxygenation, scarring, and parenchymal inflammation deserve special interest. We propose that functional MRI mechanistically provides tools for diagnostic work-up in long-term follow-up of kidney allografts.

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Assessment of renal allograft function early after transplantation with isotropic resolution diffusion tensor imaging

Cited by 46 publications

References 32 publications

Functional assessment of transplanted kidneys with magnetic resonance imaging

Functional assessment of transplanted kidneys with magnetic resonance imaging

Have we forgotten imaging prior to and after kidney transplantation?

Innovative Perspective: Gadolinium-Free Magnetic Resonance Imaging in Long-Term Follow-Up after Kidney Transplantation

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