title: Diffusion-weighted MRI in the assessment of split renal function: comparison of navigator-triggered prospective acquisition correction and breath-hold acquisition.
abstract: OBJECTIVE
  The purpose of this study was to ascertain whether prospective acquisition correction (PACE) diffusion-weighted MRI (DWI) is superior to conventional breath-hold DWI in assessment of split renal function.
  
  
  METHODS
  Fifty-four subjects underwent coronal breath-hold DWI and PACE DWI with the b value set at 0 and 800 s/mm(2). Isotope renographic glomerular filtration rate (GFR) was used as the reference standard for assessing split renal function. A GFR of 40 mL/min or greater indicated normal and a GFR less than 40 mL/min indicated reduced split renal function. Reduced split renal function was further divided into a mild reduction group (GFR ≥ 20 mL/min) and a moderate-to-severe reduction group (GFR < 20 mL/min). Various comparisons between the imaging methods were conducted.
  
  
  RESULTS
  The signal-to-noise and contrast-to-noise ratios of the PACE DW images were greater than those of the breath-hold DW images (p < 0.001). The correlation between the apparent diffusion coefficient (ADC) value and GFR was stronger when the ADC was measured with PACE DWI than with breath-hold DWI (p = 0.033). Area under the receiver operator curve (AUC) analysis revealed that PACE DWI (AUC, 0.790 ± 0.045; p < 0.001) but not breath-hold DWI (AUC, 0.616 ± 0.060; p = 0.053) had diagnostic value in predicting a reduction in split renal function. ADC value assessed with PACE DWI was lower in the groups with mild and moderate-to-severe reduction in split renal function than in the group with normal function (p < 0.01).
  
  
  CONCLUSIONS
  Preliminary results imply that PACE DWI is superior to breath-hold DWI in the assessment of split renal function.
authors.affiliation: Department of Radiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Li
authors.forename: Xinying
authors.initials: X
authors.lastname: Wu
authors.forename: Lingling
authors.initials: L
authors.lastname: Qiu
authors.forename: Peipei
authors.initials: P
authors.lastname: Zhang
authors.forename: Minming
authors.initials: M
authors.lastname: Zhang
authors.forename: Fuhua
authors.initials: F
authors.lastname: Yan
mesh_terms: D000328:Adult; D062485:Breath Holding; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011866:Radioisotope Renography; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*