title: Kidney transplant: functional assessment with diffusion-tensor MR imaging at 3T.
abstract: OBJECTIVE
  To evaluate the feasibility of diffusion-tensor (DT) imaging at 3 T for functional assessment of transplanted kidneys.
  
  
  METHODS
  This study was approved by the local ethics committee; written informed consent was obtained. Between August 2009 and October 2010, 40 renal transplant recipients were prospectively included in this study and examined with a clinical 3-T magnetic resonance (MR) imager. An echo-planar DT imaging sequence was performed in coronal orientation by using five b values (0, 200, 400, 600, 800 sec/mm(2)) and 20 diffusion directions. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were determined for the cortex and medulla of the transplanted kidney. Relationships between FA, ADC, and allograft function, determined by the estimated glomerular filtration rate (eGFR), were assessed by using Pearson correlation coefficient. ADC and FA were compared between patients with good or moderate allograft function (group A; eGFR > 30 mL/min/1.73 m(2)) and patients with impaired function (group B; eGFR ≤ 30 mL/min/1.73 m(2)) by using a student t test. P < .05 indicated a statistically significant difference.
  
  
  RESULTS
  Mean FA of the renal medulla and cortex was significantly higher in group A (0.39 ± 0.06 and 0.17 ± 0.4) compared with group B (0.27 ± 0.05 and 0.14 ± 0.03) (P < .001 and P = .009, respectively). Mean ADCs of renal cortex and medulla were significantly higher in group A than in group B (P = .007 and P = .01, respectively). In group B, mean medullary FA was significantly lower in patients whose renal function did not recover (0.22 ± 0.02) compared with those with stable allograft function at 6 months (0.29 ± 0.05, P < .001). There was significant correlation between eGFR and medullary FA (r = 0.65, P < .001), cortical ADC (r = 0.43, P = .003), and medullary ADC (r = 0.35, P = .01).
  
  
  CONCLUSIONS
  DT imaging is a promising noninvasive technique for functional assessment of renal allografts. FA values in the renal medulla exhibit a good correlation with renal function.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Moorenstr. 5, 40225 Düsseldorf, Germany. rotemshlomo@yahoo.de
authors.forename: Rotem S
authors.initials: RS
authors.lastname: Lanzman
authors.forename: Alexandra
authors.initials: A
authors.lastname: Ljimani
authors.forename: Gael
authors.initials: G
authors.lastname: Pentang
authors.forename: Panagiota
authors.initials: P
authors.lastname: Zgoura
authors.forename: Hakan
authors.initials: H
authors.lastname: Zenginli
authors.forename: Patric
authors.initials: P
authors.lastname: Kröpil
authors.forename: Philipp
authors.initials: P
authors.lastname: Heusch
authors.forename: Julia
authors.initials: J
authors.lastname: Schek
authors.forename: Falk R
authors.initials: FR
authors.lastname: Miese
authors.forename: Dirk
authors.initials: D
authors.lastname: Blondin
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.forename: Hans-Jörg
authors.initials: HJ
authors.lastname: Wittsack
mesh_terms: D000328:Adult; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006084:Graft Rejection / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology*; D007677:Kidney Function Tests / Q000379:methods; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000473:pathology*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome