The Role of Diffusion-Weighted MRI and Apparent Diffusion Coefficient in the Evaluation of Early Renal Allograft Dysfunction
Iraqi Postgraduate Medical Journal,
2017, Volume 16, Issue 1, Pages 35-40
The most common complication of allografted kidney is renal allograft dysfunction which in some cases results in graft loss, the Diffusion Weighted-Magnetic Resonant Imaging (DW-MRI) and Apparent Diffusion Coefficient (ADC) value may provide a useful insight into the underlying pathology of renal allograft dysfunction.
To evaluate the utility and diagnostic performance of the DW-MRI and its ADC value in patients with early renal allograft dysfunction.
PATIENTS AND METHODS:
An analytic prospective study was conducted at MRI unit of Al Shaheed Ghazi Al Hariri Teaching Hospital from February 2015 to the end of November 2015, a total of 57 cases were included in this study, they divided in to two groups; control group: including 30 cases with stable or normal renal allograft function and patients group: including 27 cases with early renal allograft dysfunction. All study cases underwent DW-MRI with b value=1000 sec/mm2. The ADC was reconstructed and mean ADC values were correlated with histopathological biopsy results which is done for all patients group to determine the underlying etiology.
The mean ADC values of the patients group (1.7±0.2) *10-3 mm2/s were significantly lower (p=0.001) compared with the mean ADC values in the control group (2.2±0.1) *10-3mm2/s. The cutoff ADC value between the control group and the patients group was (2.06*10-3 mm2/s). According to the morphological appearance in DWI and ADC map we can differentiate acute tubular necrosis (ATN) cases which expressed a heterogeneous appearance/mosaic pattern from acute renal allograft rejection cases and calcinurin inhibiter (CNI) nephrotoxicity cases where both expressed a homogenous morphological pattern.
DW-MR and its ADC were valuable in the assessment of the underlying etiology of early renal allograft dysfunction and there was a Cutoff ADC value between stable or normal renal allograft function cases and early renal allograft dysfunction.
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