mDIXON-Quant for differentiation of renal damage degree in patients with chronic kidney disease

Abstract

BackgroundChronic kidney disease (CKD) is a complex syndrome with high morbidity and slow progression. Early stages of CKD are asymptomatic and lack of awareness at this stage allows CKD to progress through to advanced stages. Early detection of CKD is critical for the early intervention and prognosis improvement.PurposeTo assess the capability of mDIXON-Quant imaging to detect early CKD and evaluate the degree of renal damage in patients with CKD.Study typeRetrospective.Population35 patients with CKD: 18 cases were classifified as the mild renal damage group (group A) and 17 cases were classifified as the moderate to severe renal damage group (group B). 22 healthy volunteers (group C).Field strength/sequenceA 3.0 T/T1WI, T2WI and mDIXON-Quant sequences.AssessmentTransverse relaxation rate (R2*) values and fat fraction (FF) values derived from the mDIXON-Quant were calculated and compared among the three groups.Statistical testsThe intra-class correlation (ICC) test; Chi-square test or Fisher’s exact test; Shapiro-Wilk test; Kruskal Wallis test with adjustments for multiplicity (Bonferroni test); Area under the receiver operating characteristic (ROC) curve (AUC). The significance threshold was set at P < 0.05.ResultsCortex FF values and cortex R2* values were significantly different among the three groups (P=0.028, <0.001), while medulla R2* values and medulla FF values were not (P=0.110, 0.139). Cortex FF values of group B was significantly higher than that of group A (Bonferroni adjusted P = 0.027). Cortex R2* values of group A and group B were both significantly higher than that of group C (Bonferroni adjusted P = 0.012, 0.001). The AUC of cortex FF values in distinguishing group A and group B was 0.766. The diagnostic efficiency of cortex R2* values in distinguishing group A vs. group C and group B vs. group C were 0.788 and 0.829.ConclusionThe mDIXON-Quant imaging had a potential clinical value in early diagnosis of CKD and assessing the degree of renal damage in CKD patients.