1. Intravoxel Incoherent Motion-Diffusion-Weighted MRI for Investigation of Delayed Graft Function Immediately after Kidney Transplantation.
- Author
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Chang, Yung-Chieh, Tsai, Yi-Hsin, Chung, Mu-Chih, Pan, Kuan-Jung, Ho, Hao-Chung, Chen, Hsian-Min, Ouyang, Yen-Chien, Shu, Kuo-Hsiung, Chen, Jeon-Hor, and Chai, Jyh-Wen
- Subjects
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STATISTICAL significance , *KRUSKAL-Wallis Test , *STATISTICS , *KIDNEY function tests , *HOMOGRAFTS , *FUNCTIONAL status , *KIDNEY transplantation , *MAGNETIC resonance imaging , *GRAFT survival , *POSTOPERATIVE care , *QUANTITATIVE research , *FISHER exact test , *MANN Whitney U Test , *PEARSON correlation (Statistics) , *CHI-squared test , *DATA analysis software , *DATA analysis , *RECEIVER operating characteristic curves , *DEMOGRAPHY - Abstract
Purpose. A non-invasive way of assessing post-transplant renal graft function has been needed. This study aimed to assess the micro-structural and micro-functional status of graft kidneys by using intravoxel incoherent motion- (IVIM-) diffusion-weighted imaging (DWI) to investigate delayed graft function (DGF) immediately after transplantation. Method. A prospective study was conducted on 37 patients, 14 with early graft function (EGF) and 23 with DGF (9 with complication, 14 without) who underwent IVIM-DWI, most often within 1-7 days after kidney transplantation. A total of 37 cases were collected and all the participants have been well-informed and signed their consents. In addition, the study conducted in this paper was approved by the Ethics Committee of Clinical Research, Taichung Veterans General Hospital (IRB number: CE14065). Using biexponential analysis of slow diffusion coefficient ( D slow ), fast diffusion coefficient ( D fast ), and perfusion fraction was performed. The apparent diffusion coefficient (ADC) was calculated by use of a monoexponential model. All parameters were measured from three different regions-of-interest (ROI), covering the entire renal parenchyma, cortex, and medulla. Results. D slow , perfusion fraction, and ADC were significantly higher in patients with EGF than DGF (all p values values <0.001). Especially, ADC measured from ROI covering the entire kidney parenchyma had the best cut-off value (1.93μm2/msec) with the highest area under the receiver operating characteristic curve (AUC 0.943) in differentiating EGF from DGF. For analysis of pair-wise differences, only the perfusion fraction values, measured from the ROI covering the renal cortex, were significantly higher in 14 DGF patients with no complications than in the 9 DGF patients with complications, with the best cut-off value of 12.3% and the AUC of 0.844. Conclusion. Noninvasive IVIM-DWI reliably differentiates DGF from EGF after kidney transplantation, and it may aid in identifying posttransplant complications and indications for renal biopsy. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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