Eur Radiol (2015) 25:652–660 DOI 10.1007/s00330-014-3461-x


Chronic kidney disease: pathological and functional assessment with diffusion tensor imaging at 3T MR Zhiling Liu & Ying Xu & Jie Zhang & Junhui Zhen & Rong Wang & Shifeng Cai & Xianshun Yuan & Qingwei Liu

Received: 25 July 2014 / Revised: 9 September 2014 / Accepted: 29 September 2014 / Published online: 11 October 2014 # European Society of Radiology 2014

Abstract Objective Our objective was to evaluate pathological and functional changes in chronic kidney disease (CKD) using diffusion tensor imaging (DTI) at 3 T. Methods There were fifty-one patients with CKD who required biopsy and 19 healthy volunteers who were examined using DTI at 3 T. The mean values of fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) were obtained from the renal parenchyma (cortex and medulla). Correlations between imaging results and the estimated glomerular filtration rate (eGFR), as well as pathological damage (glomerular lesion and tubulointerstitial injury), were evaluated. Results The renal cortical FA was significantly lower than the medullary in both normal and affected kidneys (p25-50 % ≥50 %

≤10 % 10-25 % >25-50 % ≥50 %

≤25 % 25-50 % ≥50 % Na.

≤25 % 25-50 % ≥50 % Na.

≤25 % 25-50 % ≥50 % Na.

Na. not applicable 1

Mild proliferation in a few glomerular segments


Mild proliferation in some glomerular segments


Mild proliferation in some glomerular segments or moderate proliferation in a few glomerular segments


Moderate proliferation in most glomerular segments or severe proliferation in a few glomerular segments


Eur Radiol (2015) 25:652–660

Table 3 Mean values (±standard deviation [SD]) of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in each group, as well as the pathologic score in patients FA


Cortex Control group (n=19) Study group (n=51)

0.240±0.017 b


Pathologic score




Glomerular score

Tubulointerstitial score

Total score













Na. not applicable a

p90 ml/min), the decrease in FA could be measured. Compared with renal biopsy, DTI is noninvasive and can be safely repeated to evaluate the entire organ. This imaging technology could therefore be valuable for diagnosis and follow-up in patients with CKD. Acknowledgements The scientific guarantor of this publication is Qingwei Liu. The authors of this manuscript declare no relationship with any company. This study has received funding by the National Natural Science Foundation of China (61301253), Shandong Province Science and Technolo gy Develop men t Plan (2012 GS F118 20 and 2012YD18053), and the Foundation for Outstanding Young Scientist in Shandong Province (2010BSB14072). No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. These study subjects or cohorts have not been previously reported. Methodology: prospective, diagnostic or prognostic study, performed at one institution.


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Chronic kidney disease: pathological and functional assessment with diffusion tensor imaging at 3T MR.

Our objective was to evaluate pathological and functional changes in chronic kidney disease (CKD) using diffusion tensor imaging (DTI) at 3 T...
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