Noninvasive assessment of clinical and pathological characteristics of patients with IgA nephropathy by diffusion kurtosis imaging

Ping Liang; Shichao Li; Guanjie Yuan; Kangwen He; Anqin Li; Daoyu Hu; Zhen Li; Chuou Xu

doi:10.1186/s13244-022-01158-y

Noninvasive assessment of clinical and pathological characteristics of patients with IgA nephropathy by diffusion kurtosis imaging

Insights Imaging. 2022 Jan 29;13(1):18. doi: 10.1186/s13244-022-01158-y.

Authors

Ping Liang¹, Shichao Li¹, Guanjie Yuan¹, Kangwen He¹, Anqin Li¹, Daoyu Hu¹, Zhen Li¹, Chuou Xu²

Affiliations

¹ Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
² Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China. xchuou@163.com.

Abstract

Objectives: To explore the diagnostic performance of diffusion kurtosis imaging (DKI) in evaluating the clinical and pathological characteristics of patients with immunoglobulin A nephropathy (IgAN) compared with conventional DWI.

Materials and methods: A total of 28 IgAN patients and 14 healthy volunteers prospectively underwent MRI examinations including coronal T2WI, axial T1WI, T2WI, and DWI sequences from September 2020 to August 2021. We measured mean kurtosis (MK), mean diffusivity (MD), and apparent diffusion coefficient (ADC) by using MR Body Diffusion Toolbox v1.4.0 (Siemens Healthcare). Patients were divided into three groups according to their estimated glomerular filtration rate (eGFR) (Group1, healthy volunteers without kidney disease or other diseases that affect renal function; Group2, IgAN patients with eGFR > 60 mL/min/1.73 m²; Group3, IgAN patients with eGFR < 60 mL/min/1.73 m²). One-way analysis of variance, Pearson or Spearman correlation, and receiver operating characteristic curves were applied in our statistical analysis.

Results: MK_Cortex and ADC_Cortex showed significant differences between the Group1 and Group2. MK_Cortex, MD_Cortex, ADC_Cortex, MK_Medulla, and ADC_Medulla showed significant differences between Group2 and Group3. MK_Cortex had the highest correlation with CKD stages (r = 0.749, p < 0.001), and tubulointerstitial lesion score (r = 0.656, p < 0.001). MD_Cortex had the highest correlation with glomerular lesion score (r = - 0.475, p = 0.011). MK_Cortex had the highest AUC (AUC = 0.923) for differentiating Group1 from Group2, and MD_Cortex had the highest AUC (AUC = 0.924) for differentiating Group2 from Group3, followed by MK_Medulla (AUC = 0.923).

Conclusions: DKI is a feasible and reliable technique that can assess the clinical and pathological characteristics of IgAN patients and can provide more valuable information than conventional DWI, especially MK_Cortex.

Keywords: Apparent diffusion coefficient; Diffusional kurtosis imaging; Immunoglobulin A nephropathy; Mean diffusivity; Mean kurtosis.

Abstract

Grants and funding