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Early assessment of acute kidney injury in severe acute pancreatitis with multimodal DWI: an animal model

  • Magnetic Resonance
  • Published:
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Abstract

Objectives

To evaluate the feasibility of multimodal diffusion-weighted imaging (DWI) for detecting the occurrence and severity of acute kidney injury (AKI) caused by severe acute pancreatitis (SAP) in rats.

Methods

SAP was induced in thirty rats by the retrograde injection of 5.0% sodium taurocholate through the biliopancreatic duct. Six rats underwent MRI of the kidneys 24 h before and 2, 4, 6, and 8 h after this AKI model was generated. Conventional and functional MRI sequences were used, including intravoxel incoherent motion imaging (IVIM), diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DTI). The main DWI parameters and histological results were analyzed.

Results

The fast apparent diffusion coefficient (ADC) of the renal cortex was significantly reduced at 2 h, as was the fractional anisotropy (FA) value of the renal cortex on DTI. The mean kurtosis (MK) values for the renal cortex and medulla gradually increased after model generation. The renal histopathological score was negatively correlated with the medullary slow ADC, fast ADC, and perfusion scores for both the renal cortex and medulla, as were the ADC and FA values of the renal medulla in DTI, whereas the MK values of the cortex and medulla were positively correlated (r = 0.733, 0.812). Thus, the cortical fast ADC, medullary MK, FADTI, and slow ADC were optimal parameters for diagnosing AKI. Of these parameters, cortical fast ADC had the highest diagnostic efficacy (AUC = 0.950).

Conclusions

The fast ADC of the renal cortex is the core indicator of early AKI, and the medullary MK value might serve as a sensitive biomarker for grading renal injury in SAP rats.

Clinical relevance statement

The multimodal parameters of renal IVIM, DTI, and DKI are potential beneficial for the early diagnosis and severity grading of renal injury in SAP patients.

Key Points

• The multimodal parameters of renal DWI, including IVIM, DTI, and DKI, may be valuable for the noninvasive detection of early AKI and the severity grading of renal injury in SAP rats.

• Cortical fast ADC, medullary MK, FA, and slow ADC are optimal parameters for early diagnosis of AKI, and cortical fast ADC has the highest diagnostic efficacy.

• Medullary fast ADC, MK, and FA as well as cortical MK are useful for predicting the severity grade of AKI, and the renal medullary MK value exhibits the strongest correlation with pathological scores.

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Abbreviations

AP:

Acute pancreatitis

AKI:

Acute kidney injury

CKD:

Chronic kidney disease

DKI:

Diffusion kurtosis imaging

DWI:

Diffusion-weighted imaging

FA:

Fractional anisotropy

MK:

Mean kurtosis

SAP:

Severe acute pancreatitis

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Funding

This study was supported by the General Programs of National Natural Science Foundation of China (81871440), the Youth Program of Natural Science Foundation of Sichuan Provincial Department of Science and Technology (2023NSFSC1535), the scientific research project of Sichuan Provincial Health and Family Planning Commission (21PJ102), and the Affiliated Hospital of North Sichuan Medical College (2022JB001, BS20211116).

Author information

Author notes

  1. Xinghui Li and Zenghui Li contributed equally to this work

Authors and Affiliations

  1. Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 1 South Maoyuan Street, Nanchong, 637001, China

    Xinghui Li, Zenghui Li, Lu Liu, Yu Pu, Yifan Ji, Wei Tang, Tianwu Chen & Xiaoming Zhang

  2. Department of Clinical Laboratory, Affiliated Hospital of North Sichuan Medical College, 1 South Maoyuan Street, Nanchong, 637001, Sichuan Province, China

    Qi Liang

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  1. Xinghui Li
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Correspondence to Qi Liang or Xiaoming Zhang.

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The scientific guarantor of this publication is Xinghui Li.

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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Approval from the institutional animal care committee was obtained.

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Study subjects or cohorts overlap

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Li, X., Li, Z., Liu, L. et al. Early assessment of acute kidney injury in severe acute pancreatitis with multimodal DWI: an animal model. Eur Radiol 33, 7744–7755 (2023). https://doi.org/10.1007/s00330-023-09782-y

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  • DOI: https://doi.org/10.1007/s00330-023-09782-y

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