title: Diffusion tensor imaging and tractography of the kidneys: assessment of chronic parenchymal diseases.
abstract: OBJECTIVE
  To assess renal dysfunction in chronic kidney diseases using diffusion tensor imaging (DTI).
  
  
  METHODS
  Forty-seven patients with impaired renal function (study group) and 17 patients without renal diseases (control group) were examined using DTI sequences. Cortical and medullary regions of interest (ROIs) were located to obtain the corresponding values of the apparent diffusion coefficient (ADC) and the fractional anisotropy (FA). The mean values of the ADC and FA, for each ROI site, were obtained in each group and were compared. Furthermore, the correlations between the diffusion parameters and the estimated glomerular filtration rate (eGFR) were determined.
  
  
  RESULTS
  In both the normal and affected kidneys, we obtained the cortico-medullary difference of the ADC and the FA values. The FA value in the medulla was significantly lower (P = 0.0149) in patients with renal function impairment as compared to patients with normal renal function. A direct correlation between DTI parameters and the eGFR was not found. Tractography visualised disruption of the regular arrangement of the tracts in patient with renal function alteration.
  
  
  CONCLUSIONS
  DTI could be a useful tool in the evaluation of chronic kidney disease and, in particular, the medullary FA value seems to be the main parameter for assessing renal damage.
  
  
  CONCLUSIONS
  • Magnetic resonance diffusion tensor imaging (MRDTI) provides new information about renal problems. • DTI allows non-invasive repeatable evaluation of the renal parenchyma, without contrast media. • DTI could become useful in the management of chronic parenchymal disease. • DTI seems more appropriate for renal evaluation than diffusion-weighted imaging.
authors.affiliation: Radiology Unit, Department of Digestive Diseases and Internal Medicine, University of Bologna, Via Albertoni, 15, 40138 Bologna, Italy. caterina.gaudiano@aosp.bo.it
authors.forename: Caterina
authors.initials: C
authors.lastname: Gaudiano
authors.forename: Valeria
authors.initials: V
authors.lastname: Clementi
authors.forename: Fiorenza
authors.initials: F
authors.lastname: Busato
authors.forename: Beniamino
authors.initials: B
authors.lastname: Corcioni
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Orrei
authors.forename: Emiliana
authors.initials: E
authors.lastname: Ferramosca
authors.forename: Emma
authors.initials: E
authors.lastname: Fabbri
authors.forename: Paola
authors.initials: P
authors.lastname: Berardi
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoro
authors.forename: Rita
authors.initials: R
authors.lastname: Golfieri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016880:Anisotropy; D002908:Chronic Disease; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult