1. Integrated Diffusion Tensor Imaging and Renal Parenchymal Volume for Early Detection and Grading of Split Renal Functional Impairment in Lupus Nephritis.
- Author
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Wang Y, He C, Lai S, Xu X, Cai X, Li J, Wu M, He Y, Lin J, Wang C, Wang M, Xu Y, Wei X, Jiang X, Yuan S, and Yang R
- Subjects
- Humans, Female, Male, Adult, Early Diagnosis, Middle Aged, Sensitivity and Specificity, Organ Size, Radioisotope Renography methods, Case-Control Studies, Young Adult, Lupus Nephritis diagnostic imaging, Diffusion Tensor Imaging methods, Glomerular Filtration Rate, Kidney diagnostic imaging
- Abstract
Rationale and Objectives: To investigate the effectiveness of combining split diffusion tensor imaging (DTI) measurements with split renal parenchymal volume (RPV) for assessing split renal functional impairment in patients with lupus nephritis (LN)., Materials and Methods: Seventy-four participants [48 LN patients and 26 healthy volunteers (HV)] were included in the study. All participant underwent conventional MR and DTI (b = 0, 400, and 600 s/mm
2 ) examinations using a 3.0 T MRI scanner to determine the split renal DTI measurements and split RPV. In LN patients, renography glomerular filtration rate (rGFR) was measured using99m Tc-DTPA scintigraphy based on Gates' method, serving as the reference standard to categorize all split kidneys of LN patients into LN with mild impairment (LNm , n = 65 kidneys) and LN with moderate to severe (LNms , n = 31 kidneys) groups according to the threshold of 30 ml/min in spilt rGFR. All statistical analyses were performed using SPSS 25.0 and MedCalc 20.0 software packages., Results: Only split medullary fractional anisotropy (FA) and the product of split medullary FA and RPV could distinguish pairwise subgroups among the HV and each LN subgroup (all p < 0.05). ROC curve analysis demonstrated that split medullary FA (AUC = 0.866) significantly outperformed other parameters in differentiating HV from LNm groups, while the product of split medullary FA and split RPV was superior in distinguishing LNm and LNms groups (AUC = 0.793) than other parameters. The combination of split medullary FA and split RPV showed best correlation with split rGFR (r = 0.534, p < 0.001)., Conclusion: Split medullary FA, and its combination with split RPV, are valuable biomarkers for detecting early functional changes in renal alterations and predicting disease progression in patients with LN., Competing Interests: Declaration of Competing Interest No conflict of interest exists in the submission of this manuscript, and all authors have approved the enclosed manuscript for publication. I promise on behalf of my co-authors that the work described has been neither published previously nor submitted for publication elsewhere., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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