Abstract
PurposeThis study aimed to investigate the value of diffusion tensor imaging to assess renal injury in a rat model of preclinical diabetic nephropathy.MethodsTwenty-eight male Sprague Dawley rats were divided into two groups: the normal control (NC) group of 10 rats and the diabetic nephropathy (DN) group of 18 rats. Eight weeks after diabetes induction by streptozotocin, 3.0-T magnetic resonance (MR) imaging (b = 0 and 600 s/mm2, 15 diffusion directions) using a 32-channel knee coil was performed. After MR imaging, we measured serum creatinine, and collected double kidney tissues for pathology. The apparent diffusion coefficients(ADC) and fractional anisotropy(FA) values of the renal cortex and medulla were calculated for all kidneys. Physiological parameters, laboratory parameters, and imaging results were compared between the two groups.ResultsAll DN group animals developed hyperglycemia, polyuria, and emaciation. Serum creatinine was not significantly different between the groups (P > 0.05). Urinary albumin at 2, 4, and 8 weeks was higher in the DN group than in the NC group but <20 µg/min (P < 0.05). Pathologically, renal damage in the DN rats was observed. The ADC value was significantly increased in DN animals in the cortex (1.75×10-3mm2/s),medulla(1.53×10-3mm2/s)compared with NC group(cortex, 1.52×10-3mm2/s; medulla,1.35×10-3mm2/s). The FA value was significantly reduced in DN animals in the cortex (0.21),medulla(0.25)compared with NC group(cortex,0.26;medulla,0.3).ConclusionsIncreased apparent diffusion coefficients and decreased fractional anisotropy values on diffusion tensor imaging were associated with preclinical DN. Diffusion tensor imaging may be useful in early, non-invasive, quantitative detection, and therapy monitoring of DN.
Highlights
As a serious microvascular complication of diabetes mellitus, diabetic nephropathy (DN) is one of the major causes of endstage renal disease [1, 2] and can induce structural changes in the kidney, including tubular dilatation, thickening of the glomerular basement membrane, and nodular and diffuse glomerulosclerosis [3]
It has been shown that the fractional anisotropy (FA) values of the renal cortex and medulla are reduced in DN patients with or without microalbuminuria relative to those in normal healthy volunteers [6, 15]
The present study showed that the FA values of the renal cortex and medulla were lower in the DN group than in the NC group
Summary
As a serious microvascular complication of diabetes mellitus, diabetic nephropathy (DN) is one of the major causes of endstage renal disease [1, 2] and can induce structural changes in the kidney, including tubular dilatation, thickening of the glomerular basement membrane, and nodular and diffuse glomerulosclerosis [3]. DTI [5, 6] is a promising non-invasive technique that can assess renal function and pathology by qualitatively and quantitatively imaging three-dimensional diffusion of water molecules. The characteristics of tissues and organs can be quantitatively reflected by ADC and FA [7].In recent years, more and more studies have used DTI to evaluate diabetic nephropathy, and found that it has potential clinical value [8, 9]. Lu [10] have suggested that the apparent diffusion coefficient and fractional anisotropy value may be viable imaging biomarkers in DTI that can reflect the pathological progression of DN. The purpose of this study was to investigate whether the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) value can be used to quantitatively evaluate renal function changes in preclinical DN and provide a non-invasive, visual, and accurate imaging method for the diagnosis of DN
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