Abstract：
OBJECTIVE: To evaluate the ability of the Intravoxel Incoherent Motion (IVIM) and monoexponentially ADC in renal allograft function in the early and late phases of transplantation, and to predict their effectiveness in discrimination of the graft pathology.
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.
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.
摘要：
目的：评估内体素不相干运动（IVIM）和单指数ADC在移植早期和晚期肾移植功能中的作用，并预测其在移植物病理学识别中的有效性。
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。
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。
