Diffusion tensor imaging of renal parenchyma in pediatric patients with
chronic kidney disease: Correlation with serum biomarkers
Abstract
Purpose: to demonstrate role of diffusion tensor imaging (DTI) in
diagnosis of pediatric chronic kidney disease (CKD) using fraction
anisotropy (FA) and apparent diffusion coefficient (ADC). Material and
methods: Prospective study done on 35 CKD patients (19 boys, 16 girls;
mean age 12.2±2.7 years) and 19 age and sex-matched volunteers. Patients
with sclerotic (n = 25) and non-sclerotic (n= 10) CKD that underwent DTI
of kidney. Results: Mean FA of renal cortex/ medulla in CKD (0.20±0.07,
and 0.18±0.08) was significantly lower (p = 0.001) from volunteers
(0.27±0.08, 0.31±0.09). Cutoff renal FA of cortex/ medulla used for
diagnosis of CKD was 0.23, and 0.22 with AUC of 0.828, 0.828 and
accuracy of 82.9%, 80.7%. Mean ADC of renal cortex/ medulla in CKD
(1.98±0.23 and 2.03±0.23 X10-3mm2/s) was significantly higher (p =
0.001) that of volunteers (1.65±0.134 and 1.68±0.16 X10-3mm2/s. Cutoff
renal ADC of cortex/medulla used to diagnosis of CKD were 1.75 and
1.85X10-3mm2/s with AUC of 0.828, 0.910, 0.828 and 0.81 and accuracy of
82.9%, 84.1%, 80.7% and 79.5%. FA of renal cortex/medulla in
sclerotic CKD was significantly different (p = 0.001) than non-sclerotic
CKD (0.26±0.07 and 0.25±0.08). The FA of renal cortex/medulla in CKD
patients correlated with serum creatinine (r = -0.468; p = 0.000, r
=-0.381; p = 0.001), e GFR (r = 0.364; p = 0.002, r = 0.318; p = 0.007).
Conclusion: FA and ADC of renal cortex/ medulla can help in diagnosis of
CKD, FA cortex/ medulla predicts sclerotic CKD and correlated with some
of serum biomarkers.