Combined application of DTI and BOLD-MRI in the assessment of renal injury with hyperuricemia

Cheng, Zhong‐Yuan; Lin, Qi-Ting; Chen, Ping-Kang; Si-Tu, Ding-Kun; Qian, Long; Feng, You‐Zhen; Cai, Xiang‐Ran

doi:10.1007/s00261-020-02804-z

Cited by 3 publications

(6 citation statements)

References 29 publications

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“…The kidney incorporates a number of functional/structural elements, including the tubular apparatus, collecting ducts and vascular system, which can all be probed by DTI using fractional anisotropy (FA) and MD. 66,67 DTI evaluations of the kidneys have been adopted in CKD, 68 diabetes mellitus, 69 ureteropelvic junction obstruction, 70 as well as AKI. 71,72 In rat models of AKI induced by contrast medium, cortical and medullary FA have been reported to be significantly decreased at 1 hour at the dosage of 4 g iodine/kg bolus injection and were ascribed to necrosis and shedding of renal tubular epithelial cells, with tubular luminal collapse.…”

Section: Diffusion Tensor Imagingmentioning

confidence: 99%

“…64 In other research, medulla and renal cortex FA values in a hyperuricemia group were significantly reduced when compared with healthy controls and suggested that reductions may have arisen from tubulointerstitial inflammatory responses and fibrosis in tubular epithelial cells. 67 Other Potential MR Techniques for AKI Investigations T1 MAPPING. T1 mapping is widely used in clinical research for its accuracy in measuring the tissue T1 relaxometry and is 74 Reprint permission was obtained).…”

Section: Diffusion Tensor Imagingmentioning

confidence: 99%

“…Diffusion tensor imaging (DTI) is well known for its accuracy in measuring tissue microstructure through the anisotropy of tissue water diffusion, using diffusion sensitive gradient fields oriented in multiple directions. The kidney incorporates a number of functional/structural elements, including the tubular apparatus, collecting ducts and vascular system, which can all be probed by DTI using fractional anisotropy (FA) and MD 66,67 …”

Section: Novel Imaging Biomarkers In Aki and Long‐term Injurymentioning

confidence: 99%

“…It was suggested that decreased FA levels may have arisen from tubular epithelial cell necrosis in the medulla. Up to date, there have been multiple reports that DTI could provide a sensitive and noninvasive detection of acute renal microstructural alterations in lung transplantation, hyperuricemia, acute pancreatitis and CA‐AKI patients 64,67,73 . Derlin et al found that renal FA values were reduced in all lung transplantation patients with AKI compared with healthy volunteers in a clinical study (Fig.…”

Section: Novel Imaging Biomarkers In Aki and Long‐term Injurymentioning

confidence: 99%

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Multiparametric Magnetic Resonance Investigations on Acute and Long‐Term Kidney Injury

Wang

et al. 2023

Magnetic Resonance Imaging

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Acute kidney injury (AKI) is a frequent complication of critical illness and carries a significant risk of short‐ and long‐term mortality. The prediction of the progression of AKI to long‐term injury has been difficult for renal disease treatment. Radiologists are keen for the early detection of transition from AKI to long‐term kidney injury, which would help in the preventive measures. The lack of established methods for early detection of long‐term kidney injury underscores the pressing needs of advanced imaging technology that reveals microscopic tissue alterations during the progression of AKI. Fueled by recent advances in data acquisition and post‐processing methods of magnetic resonance imaging (MRI), multiparametric MRI is showing great potential as a diagnostic tool for many kidney diseases. Multiparametric MRI studies offer a precious opportunity for real‐time noninvasive monitoring of pathological development and progression of AKI to long‐term injury. It provides insight into renal vasculature and function (arterial spin labeling, intravoxel incoherent motion), tissue oxygenation (blood oxygen level‐dependent), tissue injury and fibrosis (diffusion tensor imaging, diffusion kurtosis imaging, T1 and T2 mapping, quantitative susceptibility mapping). The multiparametric MRI approach is highly promising but the longitudinal investigation on the transition of AKI to irreversible long‐term impairment is largely ignored. Further optimization and implementation of renal MR methods in clinical practice will enhance our comprehension of not only AKI but chronic kidney diseases. Novel imaging biomarkers for microscopic renal tissue alterations could be discovered and benefit the preventative interventions. This review explores recent MRI applications on acute and long‐term kidney injury while addressing lingering challenges, with emphasis on the potential value of the development of multiparametric MRI for renal imaging on clinical systems.Evidence Level1Technical EfficacyStage 2

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Section: Diffusion Tensor Imagingmentioning

confidence: 99%

Section: Diffusion Tensor Imagingmentioning

confidence: 99%

Section: Novel Imaging Biomarkers In Aki and Long‐term Injurymentioning

confidence: 99%

Section: Novel Imaging Biomarkers In Aki and Long‐term Injurymentioning

confidence: 99%

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Multiparametric Magnetic Resonance Investigations on Acute and Long‐Term Kidney Injury

Wang

et al. 2023

Magnetic Resonance Imaging

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“…We found that IVIM parameters might be a sensitive predictor of early diabetic and hyperuricemic nephropathies. Also, we employed a combination of BOLD imaging and DTI to detect early-stage renal fluctuations induced by diabete [ 13 ] and and hyperuricemia [ 14 ]. However, our previous study mainly focused on the value of IVIM technique or BOLD imaging and DTI in detecting the early renal alterations in patients with hyperuricemia.…”

Section: Introductionmentioning

confidence: 99%

Multiparametric MRI analysis for the evaluation of renal function in patients with hyperuricemia: a preliminary study

et al. 2021

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Background To investigate the renal dysfunction in patients with hyperuricemia by employing a multiparametric MRI protocol, consisting of quantitative water molecule diffusion, microstructure, microscopic perfusion, and oxygenation measurements in kidneys. Materials and methods A total of 48 patients with hyperuricemia (HU) and 22 age-matched healthy control subjects (HC) were enrolled in the study. For each participant, three different functional magnetic resonance imaging (fMRI) sequences were acquired and analyzed, including intravoxel incoherent motion imaging (IVIM), diffusion tensor imaging (DTI), and blood-oxygen-level-dependent MRI (BOLD). Thereafter, an independent two-sample t-test was applied to discover the significant differences of MRI indices between the hyperuricemia (HU) and HC groups, and the specific potential biomarkers between two subgroups of HU group (asymptomatic hyperuricemia group (AH) and gouty arthritis group (GA)). Further, multivariate logistic regression analyses were performed to classify the AH from the GA group using the MRI indices with significant between-group differences. The receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated to assess the performance of each MR index for differentiation between the AH and GA groups. Results Ten parametric values of the HU group were significantly lower than those of the HC group among the 14 fMRI parameters (P < 0.05). The cortical D, D*, and f values and medullary D and R2*values had significant differences between the AH and GA groups (P < 0.05). Combining the cortical D and f values and medullary R2* value gave the best diagnostic efficacy, yielding an AUC, sensitivity, and specificity of 0.967 ± 0.022, 91.67%, and 95.83%, respectively. Conclusions A multiparametric MR analysis plays an important role in the evaluation of renal dysfunction in hyperuricemia from multiple perspectives. It could be a promising method for noninvasive detection and identification of the early-stage renal damage induced by hyperuricemia.

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mDIXON-Quant for differentiation of renal damage degree in patients with chronic kidney disease

Wang

et al. 2023

Front. Endocrinol.

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BackgroundChronic kidney disease (CKD) is a complex syndrome with high morbidity and slow progression. Early stages of CKD are asymptomatic and lack of awareness at this stage allows CKD to progress through to advanced stages. Early detection of CKD is critical for the early intervention and prognosis improvement.PurposeTo assess the capability of mDIXON-Quant imaging to detect early CKD and evaluate the degree of renal damage in patients with CKD.Study typeRetrospective.Population35 patients with CKD: 18 cases were classifified as the mild renal damage group (group A) and 17 cases were classifified as the moderate to severe renal damage group (group B). 22 healthy volunteers (group C).Field strength/sequenceA 3.0 T/T1WI, T2WI and mDIXON-Quant sequences.AssessmentTransverse relaxation rate (R2*) values and fat fraction (FF) values derived from the mDIXON-Quant were calculated and compared among the three groups.Statistical testsThe intra-class correlation (ICC) test; Chi-square test or Fisher’s exact test; Shapiro-Wilk test; Kruskal Wallis test with adjustments for multiplicity (Bonferroni test); Area under the receiver operating characteristic (ROC) curve (AUC). The significance threshold was set at P < 0.05.ResultsCortex FF values and cortex R2* values were significantly different among the three groups (P=0.028, <0.001), while medulla R2* values and medulla FF values were not (P=0.110, 0.139). Cortex FF values of group B was significantly higher than that of group A (Bonferroni adjusted P = 0.027). Cortex R2* values of group A and group B were both significantly higher than that of group C (Bonferroni adjusted P = 0.012, 0.001). The AUC of cortex FF values in distinguishing group A and group B was 0.766. The diagnostic efficiency of cortex R2* values in distinguishing group A vs. group C and group B vs. group C were 0.788 and 0.829.ConclusionThe mDIXON-Quant imaging had a potential clinical value in early diagnosis of CKD and assessing the degree of renal damage in CKD patients.

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Combined application of DTI and BOLD-MRI in the assessment of renal injury with hyperuricemia

Cited by 3 publications

References 29 publications

Multiparametric Magnetic Resonance Investigations on Acute and Long‐Term Kidney Injury

Multiparametric Magnetic Resonance Investigations on Acute and Long‐Term Kidney Injury

Multiparametric MRI analysis for the evaluation of renal function in patients with hyperuricemia: a preliminary study

mDIXON-Quant for differentiation of renal damage degree in patients with chronic kidney disease

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