Value of T1 Mapping in the Non-invasive Assessment of Renal Pathologic Injury for Chronic Kidney Disease Patients.

Wei Mao, Yuqin Ding, Xiaoqiang Ding, Caixia Fu, Bohong Cao, Dominik Nickel, Jianjun Zhou, Mengsu Zeng
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Abstract

Purpose: The objective of this study was to evaluate renal function and pathologic injury in chronic kidney disease (CKD) using T1 mapping.

Methods: We recruited fifteen healthy volunteers (HV) and seventy-five CKD patients to undergo T1 mapping examination, and renal parenchymal T1 values were measured. Spearman correlation analysis was used to evaluate the relevance between the pathologic injury score, estimated glomerular filtration rate (eGFR), and renal parenchymal T1 values. The diagnostic efficiency of T1 value in evaluating renal pathologic impairment was assessed.

Results: In all subjects, renal cortical T1 value was remarkably lower than renal medullary T1 value (P < 0.01). The renal medullary T1 value of HV was considerably lower than that of CKD patients in all stages (P < 0.05). The T1 values were negatively correlated with eGFR (cortex, r = -0.718; medulla, r = -0.645). The T1 values were positively correlated with glomerular injury score (cortex, r = 0.692; medulla, r = 0.632), tubulointerstitial injury score (cortex, r = 0.758; medulla, r = 0.690) (all P < 0.01). The area under the curve (AUC) of renal cortical and medullary T1 values were 0.914 and 0.880 to distinguish moderate-severe from mild renal injury groups. To differentiate mild renal injury group from control group, the AUC values of renal cortical and medullary T1 values were 0.879 and 0.856.

Conclusion: T1 mapping has potential application value in non-invasively assessing renal pathologic injury in CKD.

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T1 图谱在无创评估慢性肾病患者肾脏病理损伤中的价值
目的:本研究旨在利用 T1 图谱评估慢性肾脏病(CKD)的肾功能和病理损伤:我们招募了 15 名健康志愿者(HV)和 75 名 CKD 患者进行 T1 映像检查,并测量了肾实质 T1 值。斯皮尔曼相关分析用于评估病理损伤评分、估计肾小球滤过率(eGFR)和肾实质 T1 值之间的相关性。评估了 T1 值在评价肾脏病理损伤方面的诊断效率:在所有受试者中,肾皮质 T1 值明显低于肾髓质 T1 值(P < 0.01)。在所有阶段,HV 患者的肾髓质 T1 值都明显低于 CKD 患者(P < 0.05)。T1 值与 eGFR 呈负相关(皮质,r = -0.718;髓质,r = -0.645)。T1 值与肾小球损伤评分(皮层,r = 0.692;髓质,r = 0.632)、肾小管间质损伤评分(皮层,r = 0.758;髓质,r = 0.690)呈正相关(均 P <0.01)。肾皮质和髓质 T1 值的曲线下面积(AUC)分别为 0.914 和 0.880,用于区分中重度肾损伤组和轻度肾损伤组。在区分轻度肾损伤组和对照组时,肾皮质和髓质 T1 值的曲线下面积(AUC)分别为 0.879 和 0.856:T1图谱在无创评估慢性肾脏病肾脏病理损伤方面具有潜在的应用价值。
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