The Clinical Study Of Functional Magnetic Resonance Imaging In Chronic Kidney Disease

Objective: To determine the relationship between renal parenchyma(cortex andmedulla) apparent diffusion coefficient (ADC) and estimated glomerular filtration rate inchronic kidney disease(CKD).Materials and methods:54CKD patients(108kidneys) and20healthy volunteers(40kidneys) underwent DWI examination. Estimated gloumerular filtration rates calculatedfollowed the Cockcroft-Gault formula.108CKD patients were divided into5groups:gradeⅠ-20patients, gradeⅡ-14patients, grade Ⅲ-12patients, grade Ⅳ-6patients, gradeⅤ-2patients.Axial fat suppressed rurbo spin echo T2WI,fast field echo T1WI,and coronal fast echoT2WI were acquired for each patient. Diffusion–weighted (DW) images were obtained inthe axial plane with b value of500s/mm2and800s/mm2. Freehand regions of interestwere delineated in the cortex and medulla of the kidneys respectively. The renal cortex,medulla ADCs between groups were statistically compared, and relationship betweenADCs and eGFR.Results:①There was no signification statistical difference between the ADCs of leftand right renal parenchyma(cortex and medulla) in control group(P＞0.05). The ADCs ofthe chronic kidney disease group were lower than the control group(P＜0.05).②There was a positive correlation between the ADCs（both cortex andmedulla）and eGFR.(rcortexwas0.768and rmedullawas0.570when b was500s/mm2, rcortexwas0.813and rmedullarwas0.682when b was800s/mm2). ③When b values were500s/mm2and800s/mm2, there was statisticallysignificant (P <0.05) differences between the control group and CKD groups.Conclusion: ADCs of both cortex and medullar were significantly lower in impairedkidneys than normal kidneys. There was a positive correlation between the ADCs of renalparenchyma(cortex and medulla) and eGFR. Objective：To investigate the value of apparent diffusion coefficient (ADC) measuredby DWI in assessing the pathological injures degree of chronic renal disease(CKD).Materials and methods:28CKD patients intended for renal biopsy underwent DWIexamination at b values of500s/mm2and800s/mm2before renal biopsy. Renal biopsyresults were reviewed together by two experienced renal pathologists to score thepathological injures of CKD. The renal cortex, medulla ADCs between were statisticallycompared, and relationship between ADCs and score the pathological injures of CKD. Inaddition, multiple linear regression analysis was used to find out the independent factor ofADC.Results:①There was a negative correlation between the ADCs of renal parenchyma(cortex and medullar) and its pathological scores. The correlation between the cortex ADCsand pathological scores was higher at b value of800s/mm2.②The multiple linear regression analysis showed that the significant linearregression was observed between pathological scores and ADCs at b value of800s/mm2,both pathological scores and eGFR at b value of500s/mm2.Conclusion: DWI can be used to assess the degree of pathological injures in CKD．Itcould be a non-invasive modality for the evaluation of pathological lesions, guidingtherapy and follow up of CKD． Objective：Comparing the R2star of renal parenchyma(cortex and medulla) betweenthe chronic kidney disease group and the control group to evaluate the renal oxygenation.Materials and methods:54CKD patients(106kidneys) and20healthy volunteers(40kidneys) underwent BOLD examination. Estimated gloumerular filtration rates werecalculated followed the Cockcroft-Gault formula. Axial fat suppressed rurbo spin echoT2WI, fast field echo T1WI, and coronal fast echo T2WI were acquired for each patient.Blood oxygenation level-dependent (BOLD) were obtained in coronal. Freehand regions ofinterest were delineated in the cortex and medulla of the kidneys respectively. The renalcortex, medulla R2star values between groups were statistically compared, and relationshipbetween R2star values and eGFR.Results:①The R2star values of cortex and medulla were15.81±1.42and21.43±1.70, and there was signification statistical difference between them in controlgroup(P＜0.05). The R2star values of cortex and medulla were17.07±1.53and29.38±3.05in CKD group. The values of CKD group were higher than control group(P＜0.05).②There was a positive correlation between the R2star values(both cortexand medulla) and eGFR (rcortex=-0.335, rmedulla=-0.579, P＜0.05).Conclusion:3.0T BOLD-MRl is adequate for the renal R2*measurement can detecthypoxia of CKD, which have potential advantages in the evaluation of renal oxygenationas a non-invasive modality．...