METHODS: This is a prospective study included participants scanned with quantitative diffusion and perfusion sequences on a 3-T MR scanner (Philips, Ingenia); the ADC and IVIM parameters; were calculated. Correlations and regression analysis with the eGFR, transplantation periods, and pathology were assessed.
RESULTS: This study included 105 renal allograft recipients (85 males, and 20 females with mean age = 32.4 ± 11.9 years and age range = 22-61 years). There was a significant positive correlation between the whole parameters of the ADC and IVIM with eGFR however, the cortical parameters showed higher significant correlation coefficients (p < 0.001). Regression analysis revealed the most significant model can predict eGFR groups included cortical pseudo diffusion (D*) and cortical ADC (p < 0.001). In graft dysfunction eGFR was 61.5 ml/min and normal graft was 64 ml/min. This model demonstrates a high performance of an AUC 96% [0.93-0.97]. In the late transplantation, there is a higher correlation with D* compared to ADC, p-values = 0.001.
CONCLUSIONS: IVIM and ADC Values are significant biomarkers for renal allograft function assessment, cortical ADC, and D* had the highest performance even in situations with mild impairment that is not affect the eGFR yet as cases of proteinuria with normal eGFR. Furthermore, D* is superior to ADC in the late assessment of the renal transplant.
方法:这是一项前瞻性研究,包括在3-TMR扫描仪上用定量扩散和灌注序列扫描的参与者(Philips,Ingenia);计算ADC和IVIM参数。与eGFR的相关性和回归分析,移植期,和病理学进行评估。
结果:本研究包括105名肾移植受者(85名男性,和20名女性,平均年龄=32.4±11.9岁,年龄范围=22-61岁)。然而,ADC和IVIM的整个参数与eGFR之间存在显著正相关,皮质参数表现出更高的显著相关系数(p<0.001)。回归分析显示最显著的模型可以预测eGFR组包括皮质伪扩散(D*)和皮质ADC(p<0.001)。在移植物功能障碍中,eGFR为61.5ml/min,正常移植物为64ml/min。该模型证明了AUC96%[0.93-0.97]的高性能。在移植后期,与ADC相比,D*具有更高的相关性,p值=0.001。
结论:IVIM和ADC值是评估肾移植功能的重要生物标志物,皮质ADC,即使在轻度损害的情况下,D*的表现也最高,但不影响eGFR,而eGFR正常的蛋白尿病例。此外,D*在肾移植晚期评价中优于ADC。