Diffusion-weighted imaging in assessing renal pathology of chronic kidney disease: A preliminary clinical study

Objective: To investigate the clinical potential of diffusion-weighted imaging (DWI) in assessing renal pathology of chronic kidney disease (CKD). Methods: Seventy-one CKD patients and twelve healthy volunteers were examined using DWI with prospective acquisition correction. Renal biopsy specimens from the CKD patients were scored based on the severity of renal pathology and to confirm pathology type. CKD patients were divided into three groups according to pathology scores: mild, moderate, or severe. The association between renal apparent diffusion coefficient (ADC) values and pathology scores was investigated using Pearson's correlation and single factor analysis of variance. Multiple linear regression analysis was performed to explore associations between renal ADC values and pathology score, glomerular filtration rate, serum creatinine, and age. The Kruskal-Wallis H test was conducted to compare ADC values and pathology type. Results: Renal ADC values correlated negatively with pathology scores (r=-0.633, P<0.001). The ADC values among the four groups (mild, moderate, severe impairment, and controls) were significantly different (F=19.512, P<0.001). However, when patients were stratified by pathology type, no significant differences were found in ADC values among these groups (chi(2)=9.929, P=0.270). Further multiple linear regression analysis showed that only the pathology score and ADC values were related (t=-4.586, P=0.000). Conclusions: DWI has clinical potential in assessing the severity of renal pathology in CKD and shows promise as a non-invasive and effective technique to guide therapy and follow-up. (C) 2014 Elsevier Ireland Ltd. All rights reserved.