Value of Renal Diffusion-Weighted MRI as a Non-Invasive Predictor of Renal Dysfunction

Abstract
Background: Chonic kidney disease (CKD) is a widespread health trouble. Laboratory tests and differant radiological procedures are helpful for the assesing tje kidney anatomical cganges and function. Diffusion weighted (DW) MRI with the apparent diffusion coefficent (ADC) are growing fields and numerous studies have tried to estimate their value in the assessment of the renal parenchyma.
Aim of Work: To assess relationship between kidney laboratory markers and values of MR apparent diffusion cofficient (ADC) of the renal parenchyma.
Patients and Methods: A ratrosective study was made for 100 patients who were examined by DW-MRI (at 0 and 500s/mm2 b-values) for different renal lesions along the year 2017, revealed 44 patients having renal dysfunction and 56 with normal kisney function. Among those 44, 30 patients were known to have CKD. The ADC values were measured for the renal parenchyma of each kidney & compared withe those values of the control normal kidneys. Receicer operating characteristic (ROC) curve was made to specify the ADC cut-off value.
Results: Significantly lower average ADC values were noted in patients with renal dysfunction than those in patients having normal kidney function (1.69vs. 2.29 (x10-3mm2/s). An inverse correlation between the ADC value and serum creatinine was statiscally significant (r=0.778, p=0.002). The cut of ADC value for renal dysfunction was 2.0355 (x10- 3mm2/s).
Conclusion: Measured MRI ADC values can be a useful marker for prediction od renal parenchymal disease. Beside renal morphological assessment, MRI can give useful idea about the renal function though measuring the ADC values for total comoprehhensive renal assessment.