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Evaluating the renal mild tubulointerstitial damage and renal function in IgAN patients: a comparative study based on diffusion kurtosis imaging and diffusion tensor imaging

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope

Abstract

Objective

To compare the performance of 3.0 T magnetic resonance diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) in evaluation of the degree of tubulointerstitial damage and renal function in Immunoglobulin A Nephropathy (IgAN) patients.

Methods

Both DKI and DTI were performed in 40 IgAN patients and 17 healthy volunteers. IgAN patients were divided into two groups according to tubulointerstitial lesion score: Mild injury group, n = 24; Moderate-severe injury group, n = 16. DKI characteristic parameters [mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr)] and DTI parameters [fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da), radial diffusivity (Dr)] of renal cortex and medulla were measured and compared among different groups. Correlations between DKI, DTI parameters and clinicopathological characteristics were assessed. Diagnostic performance of DKI and DTI to evaluate tubulointerstitial damage of IgAN was compared.

Results

Cortical MK, Kr, Da and parenchymal Ka significantly differed among three groups (P < 0.05). Cortical MK, Kr, Ka were negatively correlated with estimated glomerular filtration rate (eGFR) (MK: r = − 0.613; Kr: r = − 0.539; Ka: r = − 0.664) and positively correlated with tubulointerstitial lesion score (MK: r = 0.655; Kr: r = 0.577; Ka: r = 0.661) (all P < 0.001). Lower correlation coefficient was found among cortical FA, MD, Dr and eGFR, tubulointerstitial lesion score (all|r|< 0.350). The AUCs of DKI and DTI parameters for differentiating Mild injury group from control group were (cortical MK 0.822, cortical Ka 0.816; cortical FA 0.515, cortical MD 0.714) and for differentiating Mild injury group from Moderate-severe injury group were (cortical MK 0.813, cortical Ka 0.831; medulla FA 0.784, medulla MD 0.586).

Conclusion

Compared with DTI, DKI was more sensitive and accurate to probe the renal function and the tubulointerstitial damage of IgAN, especially the mild tubulointerstitial damage.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by grants from the Zhejiang Traditional Chinese Medical Scientific Technology (Grant No. 2022ZB240).

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Authors and Affiliations

  1. Department of Radiology, Hangzhou Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Number 453, Road Stadium, Hangzhou, 310007, Zhejiang, China

    Youjun Cao, Feng Cui, Hua Qu, Yongsheng Zhang, Xianjie Le & Jiazhen Lin

  2. Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Number 453, Road Stadium, Hangzhou, Zhejiang, China

    Jiazhen Yin

  3. Zhejiang University School of Medicine, Number 388, Road Yuhangtang, Hangzhou, Zhejiang, China

    Minfei Hu

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  1. Youjun Cao
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Contributions

All authors contributed to the study conception and design. YC designed and performed the research; JY was responsible for renal pathological diagnosis; FC provided technical and financial support; XL collected and recorded the data; HQ and MH performed the data analysis; YZ revised manuscript. JL wrote the original draft and supervised. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jiazhen Lin.

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The authors have no competing interests to declare that are relevant to the content of this article.

Ethical approval

This study was conducted in accordance with the Declaration of Helsinki and was approved by the ethics committee of Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University (No. 2018KY002).

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All the patients (or their guardians in the case of minors) provided their written informed consent before data collection.

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Cao, Y., Yin, J., Hu, M. et al. Evaluating the renal mild tubulointerstitial damage and renal function in IgAN patients: a comparative study based on diffusion kurtosis imaging and diffusion tensor imaging. Abdom Radiol 48, 1350–1362 (2023). https://doi.org/10.1007/s00261-023-03822-3

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