La risonanza magnetica pesata in diffusione (DWI) per la quantificazione del volume delle cisti e la caratterizzazione del tessuto non cistico nella malattia policistica renale: lo studio dell’Istituto Mario Negri

Ariela Benigni
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Abstract

Beyond total kidney and cyst volume, non-cystic tissue plays an important role in autosomal dominant polycystic kidney disease (ADPKD) progression. Recent advancements in magnetic resonance imaging (MRI) offer the possibility to study kidney microstructure and function, besides anatomy. In particular, Diffusion Weighted Imaging (DWI), an MRI technique sensitive to water molecule motion (diffusion) in biological tissues, allows to investigate microstructure. This study, recently published in the European Radiology scientific journal, proposes and preliminary validates a novel method to segment cystic and non-cystic volume on DWI scans from ADPKD patients. The study also provides evidence of DWI potential in characterising non-cystic kidney tissue, denoted by higher diffusion and lower perfusion than healthy tissue, in line with its fibrotic nature and the likely presence of microcysts. Overall, this study provides evidence in support of DWI potential in ADPKD. DWI could complement existing biomarkers for noninvasively staging, monitoring, and predicting ADPKD progression and evaluating the impact of novel therapies, possibly targeting damaged non-cystic tissue besides cyst expansion.
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马里奥·内格里研究所的研究
除了肾脏和囊肿的总体积外,非囊性组织在常染色体显性多囊肾病(ADPKD)的进展中也起着重要作用。磁共振成像(MRI)的最新进展提供了研究肾脏微观结构和功能的可能性,除了解剖。特别是扩散加权成像(DWI),一种对生物组织中水分子运动(扩散)敏感的MRI技术,允许研究微观结构。这项研究最近发表在欧洲放射学科学杂志上,提出并初步验证了一种新的方法来分割ADPKD患者DWI扫描上的囊性和非囊性体积。该研究还提供了表征非囊性肾组织的DWI电位的证据,其表现为比健康组织弥散更高、灌注更低,与其纤维化性质和可能存在的微囊相一致。总的来说,本研究为DWI在ADPKD中的潜在作用提供了证据。DWI可以补充现有的生物标志物,用于无创分期、监测和预测ADPKD进展,并评估新疗法的影响,除了囊肿扩张外,还可能针对受损的非囊性组织。
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