Journal of magnetic resonance imaging : JMRI · 2026
Multiparametric MR Imaging for Detecting Early Chronic Kidney Disease and Grading Chronic Pathological Changes.
СтатьяНазвание и аннотация: Перевод в очереди
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Gu Chengli, Yang Aoran, Zheng Yang, Zhou Minghui, Li Wenjuan, Zhang Chen, Kühn Bernd, Liu Xiaomei, Ren Xiufang, Li Xue, Shi Yu
Аннотация
BACKGROUND: Conventional renal function markers, such as estimated glomerular filtration rate (eGFR), often fail to reflect occult renal parenchymal injury in early-stage chronic kidney disease (CKD). Renal biopsy is invasive, limiting longitudinal monitoring. Reliable noninvasive methods for early CKD detection and chronicity assessment are lacking.
PURPOSE: To evaluate 3D MR elastography (3D-MRE), arterial spin labeling (ASL), and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for detecting early CKD and grading its chronic changes.
STUDY TYPE: Prospective.
SUBJECTS: 96 CKD patients with renal biopsy (44 ± 13 years, 55 men) and 30 healthy controls (43 ± 15 years, 18 men).
FIELD STRENGTH/SEQUENCE: 3.0 T; multifrequency (60, 90, and 120 Hz) 3D vector MRE, pseudo-continuous arterial spin labeling (pCASL), and multi-b-value (0-2000 s/mm2) IVIM-DWI.
ASSESSMENT: MRE-derived renal stiffness (RS), ASL-derived renal blood flow (RBF), and IVIM-derived true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADC) were measured. CKD was staged from 1 to 5 according to eGFR, with Stages 1-2 defined as early CKD. Chronic changes were graded by chronicity score (CS), with CS > 4 indicating moderate-to-severe chronic changes.
STATISTICAL TESTS: Mann-Whitney U test, Kruskal-Wallis test with Bonferroni correction, intraclass correlation coefficients (ICC), Bland-Altman analysis, Spearman's rank correlation, univariable and multivariable logistic regression, area under the receiver operating characteristic curve (AUC), and DeLong's test. p < 0.05 was considered significant.
RESULTS: The combined entire RS at 90 Hz (ERS@90) and the entire D achieved the highest AUC for distinguishing healthy controls from early CKD, significantly outperforming eGFR (AUC = 0.87 vs. 0.59). In early CKD, ERS@90 was the only independent discriminatory variable of moderate-to-severe chronic changes, significantly outperforming eGFR (AUC = 0.86 vs. 0.62).
DATA CONCLUSION: 3D-MRE showed promise for noninvasive detection of early CKD and for identifying moderate-to-severe chronic changes.
EVIDENCE LEVEL: 1.
TECHNICAL EFFICACY: Stage 2.
PURPOSE: To evaluate 3D MR elastography (3D-MRE), arterial spin labeling (ASL), and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for detecting early CKD and grading its chronic changes.
STUDY TYPE: Prospective.
SUBJECTS: 96 CKD patients with renal biopsy (44 ± 13 years, 55 men) and 30 healthy controls (43 ± 15 years, 18 men).
FIELD STRENGTH/SEQUENCE: 3.0 T; multifrequency (60, 90, and 120 Hz) 3D vector MRE, pseudo-continuous arterial spin labeling (pCASL), and multi-b-value (0-2000 s/mm2) IVIM-DWI.
ASSESSMENT: MRE-derived renal stiffness (RS), ASL-derived renal blood flow (RBF), and IVIM-derived true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADC) were measured. CKD was staged from 1 to 5 according to eGFR, with Stages 1-2 defined as early CKD. Chronic changes were graded by chronicity score (CS), with CS > 4 indicating moderate-to-severe chronic changes.
STATISTICAL TESTS: Mann-Whitney U test, Kruskal-Wallis test with Bonferroni correction, intraclass correlation coefficients (ICC), Bland-Altman analysis, Spearman's rank correlation, univariable and multivariable logistic regression, area under the receiver operating characteristic curve (AUC), and DeLong's test. p < 0.05 was considered significant.
RESULTS: The combined entire RS at 90 Hz (ERS@90) and the entire D achieved the highest AUC for distinguishing healthy controls from early CKD, significantly outperforming eGFR (AUC = 0.87 vs. 0.59). In early CKD, ERS@90 was the only independent discriminatory variable of moderate-to-severe chronic changes, significantly outperforming eGFR (AUC = 0.86 vs. 0.62).
DATA CONCLUSION: 3D-MRE showed promise for noninvasive detection of early CKD and for identifying moderate-to-severe chronic changes.
EVIDENCE LEVEL: 1.
TECHNICAL EFFICACY: Stage 2.