Prognostic Significance of Diffusion-Weighted Imaging and ASL-Perfusion in Evaluation the Progression of Chronic Kidney Disease

Abstract

Objective. To determinate the significance of diffusion-weighted imaging and ASL-perfusion in evaluation the progression of chronic kidney disease.Materials and methods. The study included 77 patients with chronic kidney disease: 34 (44.2 %) men and 43 (55.8 %) women. All subjects underwent Magnetic Resonance Imaging of the kidneys, with the inclusion of diffusion-weighted imaging (DWI) and ASL (arterial spinal label) perfusion in the research protocol. These results helped divide the patients into three groups. The comparison group included 61 healthy people.Results. There is statistically significant difference data in DWI and ASL perfusion between patients with CKD and the comparison group. The comparison group has the next counts: no diffusion restriction, ADC is 4.8 ± 0.1 × 10-3 mm2 /s, ASL-perfusion is 482–496 ml/100 g/min. The first group has no diffusion restriction, ADC is 1–4 × 10-3 mm2 /s, ASL-perfusion is 390–436 ml/100 g/min, the second group has no diffusion restriction, ADC is more than 4 × 10-3 mm2 /s and ASL-perfusion 294–402 ml/100 g/min. The third group has diffusion restriction with different ADC and ASL-perfusion.Conclusion. Absence of diffusion restriction, ADC is 1–4 × 10-3 mm2 /s, ASL-perfusion is 390–436 ml/100 g/min is indication of the beginning of injury to intact nephrons, the stage of hyperfiltration (r = 0,973). Absence of diffusion restriction, ADC is more than 4 × 10-³ mm2 /s and ASL-perfusion 294–402 ml/100 g /min is risk of metabolic disorders in CKD (r = 0,981). If it has diffusion restriction with different ADC and ASL-perfusion, there is high correlation with CKD stage 3b (r = 0.923) and hypokalemia (r = 0.988). DWI and ASL perfusion must be included in the examination algorithm for patients with CKD to create a personalized diagnostic and treatment algorithm.