title: Diffusion-Weighted imaging and diffusion tensor imaging detect delayed graft function and correlate with allograft fibrosis in patients early after kidney transplantation.
abstract: To combine diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) for detection of allograft dysfunction in patients early after kidney transplantation and to correlate diffusion parameters with renal function and renal histology of allograft biopsies.
  
  
  
  Between day 4 and 11 after kidney transplantation 33 patients with initial graft function and 31 patients with delayed graft function (DGF) were examined with a 1.5T magnetic resonance imaging (MRI) scanner. DTI and DWI sequences were acquired and fractional anisotropy (FA), apparent diffusion coefficient (ADCmono), pure diffusion (ADCdiff ), and the perfusion fraction (Fp) were calculated. Kidney biopsies in 26 patients were analyzed for allograft pathology, ie, acute tubular injury, inflammation, edema, renal fibrosis, and rejection. Histological results were correlated with MRI parameters.
  
  
  
  In the renal medulla FA (0.25 ± 0.06 vs. 0.29 ± 0.06, P < 0.01) and ADCmono (1.73 ± 0.13*10(-3) vs. 1.93 ± 0.16*10(-3) mm(2) /s, P < 0.001) were significantly reduced in DGF patients compared with patients with initial function. For ADCdiff and Fp similar reductions were observed. FA and ADCmono significantly correlated with renal function (r = 0.53 and r = 0.57, P < 0.001) and were inversely correlated with the amount of renal fibrosis (r = -0.63 and r = -0.65, P < 0.05).
  
  
  
  Combined DTI and DWI detected allograft dysfunction early after kidney transplantation and correlated with allograft fibrosis. J. Magn. Reson. Imaging 2016;44:112-121.
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Hueper
authors.affiliation: Institute for Pathology, Hannover Medical School, Hannover, Germany.
authors.forename: Abedalrazag A
authors.initials: AA
authors.lastname: Khalifa
authors.affiliation: Institute for Pathology, Hannover Medical School, Hannover, Germany.
authors.forename: Jan H
authors.initials: JH
authors.lastname: Bräsen
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
authors.forename: Van Dai
authors.initials: VD
authors.lastname: Vo Chieu
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
authors.forename: Marcel
authors.initials: M
authors.lastname: Gutberlet
authors.affiliation: Clinic for Nephrology, Hannover Medical School, Hannover, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Wintterle
authors.affiliation: Clinic for General, Abdominal and Transplant Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Lehner
authors.affiliation: Clinic for General, Abdominal and Transplant Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Richter
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
authors.forename: Matti
authors.initials: M
authors.lastname: Peperhove
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Tewes
authors.affiliation: Institute for Biostatistics, Hannover Medical School, Hannover, Germany.
authors.forename: Kristina
authors.initials: K
authors.lastname: Weber
authors.affiliation: Clinic for Nephrology, Hannover Medical School, Hannover, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Haller
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Wacker
authors.affiliation: Clinic for Nephrology, Hannover Medical School, Hannover, Germany.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Gwinner
authors.affiliation: Clinic for Nephrology, Hannover Medical School, Hannover, Germany.
authors.forename: Faikah
authors.initials: F
authors.lastname: Gueler
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Hartung
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D005355:Fibrosis; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: delayed graft function; diffusion tensor imaging; diffusion weighted magnetic resonance imaging; fibrosis; kidney transplantation