Abstract
ObjectivesTo explore the diagnostic performance of diffusion kurtosis imaging (DKI) in evaluating the clinical and pathological characteristics of patients with immunoglobulin A nephropathy (IgAN) compared with conventional DWI.Materials and methodsA total of 28 IgAN patients and 14 healthy volunteers prospectively underwent MRI examinations including coronal T2WI, axial T1WI, T2WI, and DWI sequences from September 2020 to August 2021. We measured mean kurtosis (MK), mean diffusivity (MD), and apparent diffusion coefficient (ADC) by using MR Body Diffusion Toolbox v1.4.0 (Siemens Healthcare). Patients were divided into three groups according to their estimated glomerular filtration rate (eGFR) (Group1, healthy volunteers without kidney disease or other diseases that affect renal function; Group2, IgAN patients with eGFR > 60 mL/min/1.73 m2; Group3, IgAN patients with eGFR < 60 mL/min/1.73 m2). One-way analysis of variance, Pearson or Spearman correlation, and receiver operating characteristic curves were applied in our statistical analysis.ResultsMKCortex and ADCCortex showed significant differences between the Group1 and Group2. MKCortex, MDCortex, ADCCortex, MKMedulla, and ADCMedulla showed significant differences between Group2 and Group3. MKCortex had the highest correlation with CKD stages (r = 0.749, p < 0.001), and tubulointerstitial lesion score (r = 0.656, p < 0.001). MDCortex had the highest correlation with glomerular lesion score (r = − 0.475, p = 0.011). MKCortex had the highest AUC (AUC = 0.923) for differentiating Group1 from Group2, and MDCortex had the highest AUC (AUC = 0.924) for differentiating Group2 from Group3, followed by MKMedulla (AUC = 0.923).ConclusionsDKI is a feasible and reliable technique that can assess the clinical and pathological characteristics of IgAN patients and can provide more valuable information than conventional DWI, especially MKCortex.
Highlights
Immunoglobulin A nephropathy (IgAN) is the most common glomerular disease in the world, which is characterized by the presence of IgA dominant or codominant immune deposits in the glomeruli [1]
MKCortex and ADCCortex showed significant differences between the Group1 and Group2. MKCortex, MDCortex, ADCCortex, MKMedulla, and ADCMedulla showed significant differences between Group2 and Group3. MKCortex had the highest correlation with chronic kidney disease (CKD) stages (r = 0.749, p < 0.001), and tubulointerstitial lesion score (r = 0.656, p < 0.001). MDCortex had the highest correlation with glomerular lesion score (r = − 0.475, p = 0.011). MKCortex had the highest area under the curve (AUC) (AUC = 0.923) for differentiating Group1 from Group2, and MDCortex had the highest AUC (AUC = 0.924) for differentiating Group2 from Group3, followed by MKMedulla (AUC = 0.923)
Clinical characteristics Fourteen healthy volunteers and 28 IgAN patients were included in the statistical analysis
Summary
Immunoglobulin A nephropathy (IgAN) is the most common glomerular disease in the world, which is characterized by the presence of IgA dominant or codominant immune deposits in the glomeruli [1]. The incidence of IgA nephropathy is 2.5 cases per 100,000 adults per year, and its prevalence is always underestimated because not all patients with suspected renal insufficiency will undergo a kidney biopsy [2]. IgAN is a chronic and progressive disease with various clinical manifestations (from asymptomatic to gross hematuria) and nearly 14–39% patients will develop end stage renal disease (ESRD) within 20 years after diagnosis [3]. Histopathological findings, including glomerular sclerosis, renal tubular atrophy and interstitial fibrosis, are the main independent risk factors for predicting the progression of IgAN and are essential for clinical treatment and prognostic evaluation [4].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
