Sage Journals: Discover world-class research

Abstract

Background

Because renal dysfunction is a worldwide problem, accurate assessment is required for planning treatment and follow-up. Intra-voxel incoherent motion (IVIM) can isolate fast from slow water motion in well-perfused organs and may be helpful in assessing renal dysfunction.

Purpose

To determine the clinical value of IVIM in the assessment of renal dysfunction compared with a mono-exponential model.

Material and Methods

Fifty-four consecutive participants (mean age, 53.13 ± 13.96 years) were recruited into this study. The estimated glomerular filtration rate (eGFR) was calculated to classify the participants as having severe renal injury (sRI, eGFR ≤ 30 mL/min/1.73 m²) or not (non-sRI). DWI with seven b-factors was performed. Image analysis was performed by a radiologist to generate an apparent diffusion coefficient map (ADC_mon) by mono-exponential model, diffusion coefficient (D_slow and D_fast), and fraction of fast diffusion (F_fast) maps by IVIM. The circular regions of interest were placed at the interface between the cortex and medulla for parameter measurements.

Results

The ADC_mon, D_slow, D_fast, and F_fast were less in sRI than non-sRI (P < 0.05). ADC_mon and D_slow were positively related with eGFR (P < 0.05). For differentiating sRI from non-sRI, receiver operating characteristic curve indicated no significant difference between the two methods (P > 0.05). Furthermore, the correlation was 0.93 between ADC_mon and D_slow, followed by 0.57 between D_fast and F_fast, 0.48 between ADC_mon and D_fast, and 0.34 between ADC_mon and F_fast (P < 0.05).

Conclusion

The IVIM model contributed little to improving the assessment of renal dysfunction compared with a mono-exponential model.

Keywords

Magnetic resonance imaging (MRI)diffusion-weighted imaging renal function

Get full access to this article

View all access options for this article.

References

Koh

Collins

Orton

. Intravoxel incoherent motion in body diffusion-weighted MRI: reality and challenges. Am J Roentgenol 2011; 196: 1351–1361.

Le Bihan

Breton

Lallemand

. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 1988; 168: 497–505.

Brezis

Rosen

. Hypoxia of the renal medulla–its implications for disease. N Engl J Med 1995; 332: 647–655.

Yang

Williams

. Normal and transplanted rat kidneys: diffusion MR imaging at 7 T. Radiology 2004; 231: 702–709.

Liu

Liang

Liu

. Intravoxel incoherent motion (IVIM) in evaluation of breast lesions: comparison with conventional DWI. Eur J Radiol 2013; 82: e782–789.

Rheinheimer

Stieltjes

Schneider

. Investigation of renal lesions by diffusion-weighted magnetic resonance imaging applying intravoxel incoherent motion-derived parameters–initial experience. Eur J Radiol 2012; 81: e310–316.

Sano

Kawamura

Matsumae

. Effects of long-term enalapril treatment on persistent micro-albuminuria in well-controlled hypertensive and normotensive NIDDM patients. Diabetes Care 1994; 17: 420–424.

Kim

Bae

. Effects of spironolactone in combination with Angiotensin-converting enzyme inhibitors or Angiotensin receptor blockers in patients with proteinuria. Kidney Blood Press Res 2014; 39: 573–580.

Zhao

Wang

Liu

. Assessment of renal fibrosis in chronic kidney disease using diffusion-weighted MRI. Clin Radiol 2014; 69: 1117–1122.

10.

Zuo

Chen

. Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol 2006; 17: 2937–2944.

11.

Le Bihan

. Intravoxel incoherent motion perfusion MR imaging: a wake-up call. Radiology 2008; 249: 748–752.

12.

Yamada

Aung

Himeno

. Diffusion coefficients in abdominal organs and hepatic lesions: evaluation with intravoxel incoherent motion echo-planar MR imaging. Radiology 1999; 210: 617–623.

13.

Wittsack

Lanzman

Mathys

. Statistical evaluation of diffusion-weighted imaging of the human kidney. Magn Reson Med 2010; 64: 616–622.

14.

Zhang

Sigmund

Chandarana

. Variability of renal apparent diffusion coefficients: limitations of the monoexponential model for diffusion quantification. Radiology 2010; 254: 783–792.

15.

Notohamiprodjo

Reiser

Sourbron

. Diffusion and perfusion of the kidney. Eur J Radiol 2010; 76: 337–347.

16.

Liu

Zhou

Peng

. Differentiation of central gland prostate cancer from benign prostatic hyperplasia using monoexponential and biexponential diffusion-weighted imaging. Magn Reson Imaging 2013; 31: 1318–1324.

17.

Doblas

Wagner

Leitao

. Determination of malignancy and characterization of hepatic tumor type with diffusion-weighted magnetic resonance imaging: comparison of apparent diffusion coefficient and intravoxel incoherent motion-derived measurements. Invest Radiol 2013; 48: 722–728.

18.

Yoon

Lee

Baek

. Evaluation of hepatic fibrosis using intravoxel incoherent motion in diffusion-weighted liver MRI. J Comput Assist Tomogr 2014; 38: 110–116.

19.

Siddiqi

Hoogduin

Visser

. Inhibition of the renin-angiotensin system affects kidney tissue oxygenation evaluated by magnetic resonance imaging in patients with chronic kidney disease. J Clin Hypertens (Greenwich) 2014; 16: 214–218.

20.

Ichikawa

Motosugi

Ichikawa

. Intravoxel incoherent motion imaging of the kidney: alterations in diffusion and perfusion in patients with renal dysfunction. Magn Reson Imaging 2013; 31: 414–417.

21.

Wang

Jiang

. Relationship between the renal apparent diffusion coefficient and glomerular filtration rate: preliminary experience. J Magn Reson Imaging 2007; 26: 678–681.

22.

Carbone

Gaggioli

Ricci

. Diffusion-weighted magnetic resonance imaging in the evaluation of renal function: a preliminary study. Radiol Med 2007; 112: 1201–1210.

23.

Toya

Naganawa

Kawai

. Correlation between estimated glomerular filtration rate (eGFR) and apparent diffusion coefficient (ADC) values of the kidneys. Magn Reson Med Sci 2010; 9: 59–64.

24.

Choi

Kim

Chung

. Comparison of breathhold, navigator-triggered, and free-breathing diffusion-weighted MRI for focal hepatic lesions. J Magn Reson Imaging 2013; 38: 109–118.

25.

Kandpal

Sharma

Madhusudhan

. Respiratory-triggered versus breath-hold diffusion-weighted MRI of liver lesions: comparison of image quality and apparent diffusion coefficient values. Am J Roentgenol 2009; 192: 915–922.

26.