Assessment of allograft function using diffusion-weighted magnetic resonance imaging in kidney transplant patients.
Developing a non-invasive method such as diffusion-weighted magnetic resonance imaging (DWMRI) could be used as a feasible and reproducible modality in the differential diagnosis of allograft dysfunction. We assessed the functional status of the renal allograft by DWMRI and its applicability in assessment of graft dysfunction on all end-stage renal transplant patients who attained normal renal function on the 7th day post-transplantation. Follow-up imaging of the recipient allograft was performed at the end of 90 and 180 days and in case of graft dysfunction. Kidney biopsies were performed to correlate with the corresponding MRI. The apparent diffusion coefficient (ADC) maps of the cortex and medulla were obtained by studying the DWMRI. The ADC values were significantly lower in the medulla compared with the cortex in normal donor kidneys and normally functioning transplanted kidneys, while they decreased significantly when rejection occurred. The reduction in ADC values occurred both in the cortex and in the medulla, and correlated with the degree of rejection on the kidney biopsies. The ADC values increased significantly during the recovery from rejection. We conclude that DWMRI can be beneficial in the diagnosis and follow-up of transplant patients during acute rejection.
Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Anupma
A
Kaul
Raj Kumar
RK
Sharma
Rakesh Kumar
RK
Gupta
Hira
H
Lal
Abhishek
A
Yadav
Dharmendra
D
Bhadhuria
Narayan
N
Prasad
Amit
A
Gupta
D000208:Acute Disease; D064591:Allografts; D001706:Biopsy; D038524:Diffusion Magnetic Resonance Imaging; D006084:Graft Rejection / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007677:Kidney Function Tests / Q000379:methods*; D016030:Kidney Transplantation / Q000009:adverse effects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome