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Noninvasive evaluation of early diabetic nephropathy using diffusion kurtosis imaging: an experimental study

  • Magnetic Resonance
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Abstract

Objectives

To evaluate the value of renal diffusion kurtosis imaging (DKI) in the diagnosis of early diabetic nephropathy (DN) in a rat model.

Materials and methods

Forty male Zucker diabetic fatty rats that spontaneously developed type 2 diabetes mellitus (DM) and 20 age-matched nondiabetic lean Zucker rats were included. Renal DKI scans and histological examinations were performed on the rats in batches at the end of the 4th, 8th, 12th, 16th, and 20th week after DM model was built. Based on renal histopathological appearance, included animals were divided into three groups: a nondiabetic control group, a DM group without DN, and an early DN group. Mean kurtosis (MK) and mean diffusivity (MD) values of renal cortex and medulla were analyzed statistically.

Results

MK values of renal cortex and medulla tended to increase from the control group to the early DN group, respectively, while MD values tended to decrease. The cutoff MD and MK values of renal cortex and medulla showed different values in discriminating early DN from controls. Among them, cutoff MK value of medulla of 0.62 was the best parameter (sensitivity, 93.9%; specificity, 96.4%; and area under the curve, 0.95). For discriminate early DN from DM without DN and DM without DN from controls, cutoff MK value of renal cortex or medulla achieved an area under the curve of 0.76–0.85.

Conclusions

MR DKI may be valuable for the noninvasive detection of early DN, and MK value might serve as a more sensitive biomarker of early DN than MD value.

Key Points

• In this article, diffusion kurtosis imaging (DKI) was used to detect the changes in the kidneys due to early diabetic nephropathy (DN).

• MR DKI may be valuable for the noninvasive detection of early DN.

• The mean kurtosis values of renal cortex and medulla might serve as a more sensitive biomarker of early DN than the mean diffusivity values.

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Abbreviations

AZ :

Area under the curve

DKI:

Diffusion kurtosis imaging

DM:

Diabetes mellitus

DN:

Diabetic nephropathy

DTI:

Diffusion tensor imaging

MD:

Mean diffusivity

MK:

Mean kurtosis

ROC:

Receiver operating characteristic curve

ROI:

Region of interest

ZDF:

Zucker diabetic fatty

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Funding

This study was supported by the National Natural Science Foundation of China (Grant No. 81541127).

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Authors and Affiliations

  1. Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63# Wenhua Road, Shunqing District, Nanchong, 637000, Sichuan Province, China

    Haiying Zhou, Xiao Ming Zhang, Tianwu Chen & Zonglin Jing

  2. Department of Orthopedics, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China

    Jianguang Zhang

  3. Department of Radiology, Wayne State University, Detroit, MI, USA

    Jiani Hu

  4. Department of Pathology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China

    Shunhai Jian

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  1. Haiying Zhou
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  2. Jianguang Zhang
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  3. Xiao Ming Zhang
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  4. Tianwu Chen
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  5. Jiani Hu
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  6. Zonglin Jing
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  7. Shunhai Jian
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Corresponding author

Correspondence to Xiao Ming Zhang.

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The scientific guarantor of this publication is Haiying Zhou.

Conflict of interest

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.

Informed consent

Approval from the institutional animal care committee was obtained.

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Institutional Review Board approval was obtained.

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• Prospective

• Diagnostic study

• Performed at one institution

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Zhou, H., Zhang, J., Zhang, X.M. et al. Noninvasive evaluation of early diabetic nephropathy using diffusion kurtosis imaging: an experimental study. Eur Radiol 31, 2281–2288 (2021). https://doi.org/10.1007/s00330-020-07322-6

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  • DOI: https://doi.org/10.1007/s00330-020-07322-6

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