Diffusion tensor imaging in acute pyelonephritis in children

Lair, Mickaël; Renaux-Petel, Mariette; Hassani, Adnan; Cruypeninck, Yohann; Vasies, Ioana; Liard, A; Dacher, Jean‐Nicolas; Vivier, P.-H.

doi:10.1007/s00247-018-4146-4

Cited by 6 publications

(7 citation statements)

References 9 publications

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“…28 In addition to animal studies, it has been also found that DTI could replace diffusion-weighted imaging for diagnosis of acute pyelonephritis in one study. 29 In the present study, a large proportion of the studied patients presented with AKI which correlated similarly to DTI based on their functional and pathological parameters. This may also suggest a proposed value of renal DTI in evaluation of AKI patients.…”

Section: Discussionsupporting

confidence: 52%

“…Diffusion MR metrics were shown to sense flow changes in kidney induced by diuretic challenges suggesting that vascular flow, tubular dilation, water reabsorption and intratubular flow all play important roles in diffusion‐based imaging 28 . In addition to animal studies, it has been also found that DTI could replace diffusion‐weighted imaging for diagnosis of acute pyelonephritis in one study 29 . In the present study, a large proportion of the studied patients presented with AKI which correlated similarly to DTI based on their functional and pathological parameters.…”

Section: Discussionmentioning

confidence: 99%

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Diffusion Tensor Imaging in early prediction of renal fibrosis in patients with renal disease: Functional and histopathological correlations

et al. 2020

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Aim Renal fibrosis (RF) is a well‐known marker of chronic kidney disease (CKD) progression. However, renal biopsy is an available tool for evaluation of RF, non‐invasive tools are needed not only to detect but also to monitor the progression of fibrosis. The aim of this study is to evaluate the role of diffusion tensor imaging (DTI) in the assessment of renal dysfunction and RF in patients with renal disease. Methods Fifty‐six patients with renal disorders and 22 healthy controls were recruited. All participants underwent DTI. Renal biopsy was performed for all patients. Mean renal medullary and cortical fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were compared between patients and healthy controls and correlated to serum creatinine (SCr), estimated glomerular filtration rate (eGFR), 24‐h urinary protein (24h‐UPRO) and renal histopathological scores. Results Cortical FA values were significantly higher (P = .001), while cortical ADC values were significantly lower in the patients’ group (P = .002). Cortical FA values positively correlated to SCr (P = .006) and negatively correlated to eGFR (P = .03), while cortical ADC negatively correlated to percentage of sclerotic glomeruli, atrophic tubules and interstitial fibrosis (P = .001 for all variables). Medullary ADC negatively correlated to tubular atrophy (P = .02). The diagnostic performance of DTI for detecting RF was supported by ROC curve. Multiple linear regression analysis revealed that the mean cortex ADC was significantly decreased by 0.199 mg/dL for patients with >50% glomerulosclerosis in renal biopsy. Conclusion DTI appears to represent a valuable tool for the non‐invasive assessment of renal dysfunction and renal fibrosis.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Diffusion Tensor Imaging in early prediction of renal fibrosis in patients with renal disease: Functional and histopathological correlations

et al. 2020

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“…The typical findings of acute pyelonephritis using conventional DWI has been described as areas of hindered diffusion [2][3][4][5]. The same findings have been reported using DTI [18]. Multiparametric DTI provides several parameters that can be used for further characterization of these findings.…”

Section: Discussionmentioning

confidence: 62%

“…Recent studies have shown the potential of the technique to evaluate renal pathology in older children [13][14][15][16][17]. It has also been shown that free breathing DTI is feasible and can generate images with higher quality compared to conventional DWI in children with acute pyelonephritis [18]. To our knowledge, there are no studies on renal DTI in young infants, a patient group that would benefit from the use of this noninvasive, non-radiating, short scan technique.…”

Section: Introductionmentioning

confidence: 99%

Diffusion tensor imaging based multiparametric characterization of renal lesions in infants with urinary tract infections: an explorative study

et al. 2021

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Background Conventional diffusion weighted imaging (DWI) is a promising non-invasive tool in the evaluation of infants with symptomatic urinary tract infections (UTI). The use of multiparametric diffusion tensor imaging (DTI) provides further information on renal pathology by reflecting renal microstructure. However, its potential to characterize and distinguish between renal lesions, such as acute pyelonephritic lesions, permanent renal damages or dysplastic changes has not been shown. This study aimed to evaluate the potential of multiparametric DTI for characterization of renal lesions with purpose to distinguish acute pyelonephritis from other renal lesions in young infants with their first UTI. Methods Nine kidneys in seven infants, age 1.0–5.6 months, with renal lesions i.e. uptake reductions, on acute scintigraphy performed after their first UTI, were included. The DTI examinations were performed during free breathing without sedation. The signal in the lesions and in normal renal tissue was measured in the following images: b0, b700, apparent diffusion coefficient (ADC), and fractional anisotropy (FA). In addition, DTI tractographies were produced for visibility. Results There was a difference between lesions and normal tissue in b700 signal (197 ± 52 and 164 ± 53, p = 0.011), ADC (1.22 ± 0.11 and 1.45 ± 0.15 mm2/s, p = 0.008), and FA (0.18 ± 0.03 and 0.30 ± 0.10, p = 0.008) for all nine kidneys. Six kidneys had focal lesions with increased b700 signal, decreased ADC and FA indicating acute inflammation. In three patients, the multiparametric characteristics of the lesions were diverging. Conclusion Multiparametric DTI has the potential to further characterize and distinguish acute pyelonephritis from other renal lesions in infants with symptomatic UTI.

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“…In the acute phase, ADC difference was significant between affected and unaffected tissue and showed excellent discriminatory ability [85]. Other studies confirm the ability of DWI and DTI to detect renal infection in kidneys and diffusion parameters could play an important role in monitoring treatment effectiveness [85][86][87][88]. DWI combined with chemokine receptor CXCR4 targeted positron emission tomography (PET) was able to detect allograft infection, lower UTI and non-urologic infections elsewhere, by the identification of leukocyte infiltration [89].…”

Section: Diffusion Biomarkersmentioning

confidence: 86%

MRI for diagnosis of post-renal transplant complications: current state-of-the-art and future perspectives

Schutter

Lantinga

Borra

et al. 2019

Magn Reson Mater Phy

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Kidney transplantation has developed into a widespread procedure to treat end stage renal failure, with transplantation results improving over the years. Postoperative complications have decreased over the past decades, but are still an important cause of morbidity and mortality. Early accurate diagnosis and treatment is the key to prevent renal allograft impairment or even graft loss. Ideally, a diagnostic tool should be able to detect post-transplant renal dysfunction, differentiate between the different causes and monitor renal function during and after therapeutic interventions. Non-invasive imaging modalities for diagnostic purposes show promising results. Magnetic resonance imaging (MRI) techniques have a number of advantages, such as the lack of ionizing radiation and the possibility to obtain relevant tissue information without contrast, reducing the risk of contrast-induced nephrotoxicity. However, most techniques still lack the specificity to distinguish different types of parenchymal diseases. Despite some promising outcomes, MRI is still barely used in the post-transplantation diagnostic process. The aim of this review is to survey the current literature on the relevance and clinical applicability of diagnostic MRI modalities for the detection of various types of complications after kidney transplantation.

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Diffusion tensor imaging in acute pyelonephritis in children

Abstract: Diffusion tensor imaging could replace diffusion-weighted imaging for diagnosis of acute pyelonephritis.

Cited by 6 publications

References 9 publications

Diffusion Tensor Imaging in early prediction of renal fibrosis in patients with renal disease: Functional and histopathological correlations

Diffusion Tensor Imaging in early prediction of renal fibrosis in patients with renal disease: Functional and histopathological correlations

Diffusion tensor imaging based multiparametric characterization of renal lesions in infants with urinary tract infections: an explorative study

MRI for diagnosis of post-renal transplant complications: current state-of-the-art and future perspectives

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