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Wang B, Wang Y, Wang J, Jin C, Zhou R, Guo J, Zhang H, Wang M. Multiparametric Magnetic Resonance Investigations on Acute and Long-Term Kidney Injury. J Magn Reson Imaging 2024; 59:43-57. [PMID: 37246343 DOI: 10.1002/jmri.28784] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 04/29/2023] [Accepted: 05/01/2023] [Indexed: 05/30/2023] Open
Abstract
Acute kidney injury (AKI) is a frequent complication of critical illness and carries a significant risk of short- and long-term mortality. The prediction of the progression of AKI to long-term injury has been difficult for renal disease treatment. Radiologists are keen for the early detection of transition from AKI to long-term kidney injury, which would help in the preventive measures. The lack of established methods for early detection of long-term kidney injury underscores the pressing needs of advanced imaging technology that reveals microscopic tissue alterations during the progression of AKI. Fueled by recent advances in data acquisition and post-processing methods of magnetic resonance imaging (MRI), multiparametric MRI is showing great potential as a diagnostic tool for many kidney diseases. Multiparametric MRI studies offer a precious opportunity for real-time noninvasive monitoring of pathological development and progression of AKI to long-term injury. It provides insight into renal vasculature and function (arterial spin labeling, intravoxel incoherent motion), tissue oxygenation (blood oxygen level-dependent), tissue injury and fibrosis (diffusion tensor imaging, diffusion kurtosis imaging, T1 and T2 mapping, quantitative susceptibility mapping). The multiparametric MRI approach is highly promising but the longitudinal investigation on the transition of AKI to irreversible long-term impairment is largely ignored. Further optimization and implementation of renal MR methods in clinical practice will enhance our comprehension of not only AKI but chronic kidney diseases. Novel imaging biomarkers for microscopic renal tissue alterations could be discovered and benefit the preventative interventions. This review explores recent MRI applications on acute and long-term kidney injury while addressing lingering challenges, with emphasis on the potential value of the development of multiparametric MRI for renal imaging on clinical systems. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Bin Wang
- Department of Medical Imaging, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yongfang Wang
- Department of Medical Imaging, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jing Wang
- Department of Nuclear Medicine and PET Center, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Chentao Jin
- Department of Nuclear Medicine and PET Center, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Rui Zhou
- Department of Nuclear Medicine and PET Center, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Jinxia Guo
- GE Healthcare, MR Research China, Beijing, China
| | - Hong Zhang
- Department of Nuclear Medicine and PET Center, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
- Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China
- College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
| | - Min Wang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China
- College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
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Wang Y, Ju Y, An Q, Lin L, Liu AL. mDIXON-Quant for differentiation of renal damage degree in patients with chronic kidney disease. Front Endocrinol (Lausanne) 2023; 14:1187042. [PMID: 37547308 PMCID: PMC10402729 DOI: 10.3389/fendo.2023.1187042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Background Chronic kidney disease (CKD) is a complex syndrome with high morbidity and slow progression. Early stages of CKD are asymptomatic and lack of awareness at this stage allows CKD to progress through to advanced stages. Early detection of CKD is critical for the early intervention and prognosis improvement. Purpose To assess the capability of mDIXON-Quant imaging to detect early CKD and evaluate the degree of renal damage in patients with CKD. Study type Retrospective. Population 35 patients with CKD: 18 cases were classifified as the mild renal damage group (group A) and 17 cases were classifified as the moderate to severe renal damage group (group B). 22 healthy volunteers (group C). Field strength/sequence A 3.0 T/T1WI, T2WI and mDIXON-Quant sequences. Assessment Transverse relaxation rate (R2*) values and fat fraction (FF) values derived from the mDIXON-Quant were calculated and compared among the three groups. Statistical tests The intra-class correlation (ICC) test; Chi-square test or Fisher's exact test; Shapiro-Wilk test; Kruskal Wallis test with adjustments for multiplicity (Bonferroni test); Area under the receiver operating characteristic (ROC) curve (AUC). The significance threshold was set at P < 0.05. Results Cortex FF values and cortex R2* values were significantly different among the three groups (P=0.028, <0.001), while medulla R2* values and medulla FF values were not (P=0.110, 0.139). Cortex FF values of group B was significantly higher than that of group A (Bonferroni adjusted P = 0.027). Cortex R2* values of group A and group B were both significantly higher than that of group C (Bonferroni adjusted P = 0.012, 0.001). The AUC of cortex FF values in distinguishing group A and group B was 0.766. The diagnostic efficiency of cortex R2* values in distinguishing group A vs. group C and group B vs. group C were 0.788 and 0.829. Conclusion The mDIXON-Quant imaging had a potential clinical value in early diagnosis of CKD and assessing the degree of renal damage in CKD patients.
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Affiliation(s)
- Yue Wang
- First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Ye Ju
- First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Qi An
- First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Liangjie Lin
- Clinical and Technical Support, Philips Healthcare, Beijing, China
| | - Ai Lian Liu
- First Affiliated Hospital, Dalian Medical University, Dalian, China
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Feng YZ, Dong XN, Lin QT, Chen PK, Xiong XQ, DingKun S, Qian L, Cheng ZY, Cai XR. Multiparametric MRI analysis for the evaluation of renal function in patients with hyperuricemia: a preliminary study. BMC Med Imaging 2021; 21:139. [PMID: 34583652 PMCID: PMC8477479 DOI: 10.1186/s12880-021-00675-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background To investigate the renal dysfunction in patients with hyperuricemia by employing a multiparametric MRI protocol, consisting of quantitative water molecule diffusion, microstructure, microscopic perfusion, and oxygenation measurements in kidneys. Materials and methods A total of 48 patients with hyperuricemia (HU) and 22 age-matched healthy control subjects (HC) were enrolled in the study. For each participant, three different functional magnetic resonance imaging (fMRI) sequences were acquired and analyzed, including intravoxel incoherent motion imaging (IVIM), diffusion tensor imaging (DTI), and blood-oxygen-level-dependent MRI (BOLD). Thereafter, an independent two-sample t-test was applied to discover the significant differences of MRI indices between the hyperuricemia (HU) and HC groups, and the specific potential biomarkers between two subgroups of HU group (asymptomatic hyperuricemia group (AH) and gouty arthritis group (GA)). Further, multivariate logistic regression analyses were performed to classify the AH from the GA group using the MRI indices with significant between-group differences. The receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated to assess the performance of each MR index for differentiation between the AH and GA groups. Results Ten parametric values of the HU group were significantly lower than those of the HC group among the 14 fMRI parameters (P < 0.05). The cortical D, D*, and f values and medullary D and R2*values had significant differences between the AH and GA groups (P < 0.05). Combining the cortical D and f values and medullary R2* value gave the best diagnostic efficacy, yielding an AUC, sensitivity, and specificity of 0.967 ± 0.022, 91.67%, and 95.83%, respectively. Conclusions A multiparametric MR analysis plays an important role in the evaluation of renal dysfunction in hyperuricemia from multiple perspectives. It could be a promising method for noninvasive detection and identification of the early-stage renal damage induced by hyperuricemia. Supplementary Information The online version contains supplementary material available at 10.1186/s12880-021-00675-4.
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Affiliation(s)
- You-Zhen Feng
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Xiang-Nan Dong
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China.,Department of Nephrology, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Qi-Ting Lin
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Ping-Kang Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Xiao-Qing Xiong
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - SiTu DingKun
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Long Qian
- MR Research, GE Healthcare, Beijing, China
| | - Zhong-Yuan Cheng
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China.
| | - Xiang-Ran Cai
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, Guangdong, China.
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