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Role of diffusion-weighted MRI in diagnosis of acute renal allograft dysfunction: a prospective preliminary study
- Publication Year :
- 2012
- Publisher :
- The British Institute of Radiology., 2012.
-
Abstract
- The aim was to evaluate the effects of diagnostic performance of diffusion-weighted (DW) MRI in the assessment of acute impairment of transplanted kidneys.From January 2009 to January 2010, 49 patients with stable renal allograft function (Group 1) and 21 patients with acute graft impairment (Group 2) were included in the study. All patients were evaluated with coronal T(2) weighted (T(2)W) and DW MRI of the kidney. Patients in Group 2 underwent graft biopsy to determine the underlying histopathological aetiology. Apparent diffusion coefficient (ADC) was calculated and the kidneys were studied for any areas of diffusion restriction. Two radiologists, who were blinded to the results of histopathology, independently interpreted the T(2)W and DW images.The histopathological diagnosis of Group 2 (21 patients) was acute cellular rejection (ACR) in 10, acute tubular necrosis (ATN) in 7 and immunosuppressive toxicity in 4 patients. ADC values in Group 1 were significantly higher compared with Group 2 (p0.001), patients with ACR (p0.001), patients with ATN (p0.001) and patients with drug toxicity (p0.001). Using 2 × 10(-3) mm(2) s(-1) as a cut-off, there was no overlap between the ADC values of patients with normal graft function and those with ATN. Both ACR and ATN had a low ADC value, but on the ADC map the kidney in cases of ATN appears heterogeneous with a characteristic mosaic pattern resembling the Tiger skin. There was no significant T(2)W morphological difference between the two groups.These results show how DW MRI is a promising new technique for the diagnosis of acute renal transplant dysfunction.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Delayed Graft Function
Young Adult
Biopsy
Medicine
Effective diffusion coefficient
Humans
Radiology, Nuclear Medicine and imaging
Prospective Studies
Prospective cohort study
Child
Acute tubular necrosis
Kidney transplantation
Kidney
medicine.diagnostic_test
Full Paper
business.industry
General Medicine
Middle Aged
medicine.disease
Kidney Transplantation
medicine.anatomical_structure
Diffusion Magnetic Resonance Imaging
Acute Disease
Histopathology
Female
Radiology
business
Diffusion MRI
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....29bf38a61d2a91edefe5416c1fb0e223