title: Diffusion-weighted imaging in assessing renal pathology of chronic kidney disease: A preliminary clinical study.
abstract: OBJECTIVE
  To investigate the clinical potential of diffusion-weighted imaging (DWI) in assessing renal pathology of chronic kidney disease (CKD).
  
  
  METHODS
  Seventy-one CKD patients and twelve healthy volunteers were examined using DWI with prospective acquisition correction. Renal biopsy specimens from the CKD patients were scored based on the severity of renal pathology and to confirm pathology type. CKD patients were divided into three groups according to pathology scores: mild, moderate, or severe. The association between renal apparent diffusion coefficient (ADC) values and pathology scores was investigated using Pearson's correlation and single factor analysis of variance. Multiple linear regression analysis was performed to explore associations between renal ADC values and pathology score, glomerular filtration rate, serum creatinine, and age. The Kruskal-Wallis H test was conducted to compare ADC values and pathology type.
  
  
  RESULTS
  Renal ADC values correlated negatively with pathology scores (r=-0.633, P<0.001). The ADC values among the four groups (mild, moderate, severe impairment, and controls) were significantly different (F=19.512, P<0.001). However, when patients were stratified by pathology type, no significant differences were found in ADC values among these groups (χ(2)=9.929, P=0.270). Further multiple linear regression analysis showed that only the pathology score and ADC values were related (t=-4.586, P=0.000).
  
  
  CONCLUSIONS
  DWI has clinical potential in assessing the severity of renal pathology in CKD and shows promise as a non-invasive and effective technique to guide therapy and follow-up.
authors.affiliation: Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Jinning
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Minming
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. Electronic address: zemylife@163.com.
authors.forename: Fuhua
authors.initials: F
authors.lastname: Yan
mesh_terms: D000328:Adult; D000465:Algorithms; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007668:Kidney / Q000473:pathology*; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Chronic kidney disease; Diffusion-weighted imaging; Pathology