Role of diffusion-weighted magnetic resonance imaging in evaluation of chronic kidney disease

Abstract

Objective The aim was to assess diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) of the renal parenchyma role in evaluation of different chronic kidney disease stages. Introduction MRI has a special ability to evaluate both renal structure and function objectively without any radiation hazards. Patients and methods This study enrolled 38 patients with chronic kidney disease (CKD) and 30 participants as healthy volunteers (sex and age matched). Abdominal MRIs with DWI results were compared with the level of estimated glomerular filtration rate. Results There were no significant differences in the ADC values of our studied patients between the right and left kidneys or between male and female. The entire control group had facilitated diffusion, whereas 70 and 30% patients with CKD had facilitated and restricted diffusion, respectively. Patients with CKD had significantly lower ADC in comparison with control group. The mean ADC was significantly decreasing with advancing stage of CKD, where stage I CKD had the highest mean ADC, whereas stage V CKD had lowest mean ADC. The ADC had a negative weak correlation with serum creatinine (r = −0.30; P = 0.04) but a positive moderate correlation with creatinine clearance (r = 0.56; P = 0.01). Conclusion The renal ADC had 86% sensitivity and 100% specificity in diagnosing chronic kidney disease, so the authors can depend on DWI and ADC in diagnosis and differentiating CKD stages.