To assess whether MR diffusion imaging may be applied for non-invasive detection of renal changes correlating with clinical diagnosis of acute kidney injury (AKI) in patients after lung transplantation (lutx). Fifty-four patients (mean age 49.6, range 26–64 years) after lutx were enrolled in a prospective clinical study and underwent functional MR imaging of the kidneys in the early postoperative period. Baseline s-creatinine ranged from 39 to 112 μmol/L. For comparison, 14 healthy volunteers (mean age 42.1, range 24–59 years) underwent magnetic resonance imaging (MRI) using the same protocol. Renal tissue injury was evaluated using quantification of diffusion and diffusion anisotropy with diffusion-weighted (DWI) and diffusion-tensor imaging (DTI). Renal function was monitored and AKI was defined according to Acute-Kidney-Injury-Network criteria. Statistical analysis comprised one-way ANOVA and Pearson correlation. 67% of lutx patients (36/54) developed AKI, 47% (17/36) had AKI stage 1, 42% (15/36) AKI stage 2, and 8% (3/36) severe AKI stage 3. Renal apparent diffusion coefficients (ADCs) were reduced in patients with AKI, but preserved in transplant patients without AKI and healthy volunteers (2.07 ± 0.02 vs 2.18 ± 0.05 vs 2.21 ± 0.03 × 10 –3 mm 2 /s, P .05). Diffusion anisotropy was reduced in all lutx recipients compared with healthy volunteers (AKI: 0.27 ± 0.01 vs no AKI: 0.28 ± 0.01 vs healthy: 0.33 ± 0.02; P .01). Reduction of renal ADC correlated significantly with acute loss of renal function after lutx (decrease of renal function in the postoperative period and glomerular filtration rate on the day of MRI). MR diffusion imaging enables non-invasive assessment of renal changes correlating with AKI early after lutx. Reduction of diffusion anisotropy was present in all patients after lutx, whereas marked reduction of renal ADC was observed only in the group of lutx recipients with AKI and correlated with renal function impairment.
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机译：为了评估MR扩散成像是否可以应用于肾移植（LUTX）后患者患者急性肾损伤（AKI）临床诊断的肾变化的非侵入性检测。在术后期间术后，在术后期初临床研究和术后肾脏的前瞻性临床研究和肾功能术后，患有五十四名患者（平均49.6，范围26-64岁）。基线S-肌酐范围为39至112μmol/升。对于比较，14名健康志愿者（平均42.1，24-59岁）使用相同的方案接受磁共振成像（MRI）。使用扩散和扩散各向异性的量化评估肾组织损伤，其与扩散加权（DWI）和扩散张测成像（DTI）。监测肾功能，并根据急性肾伤害网络标准定义AKI。统计分析包括单向Anova和Pearson相关性。 67％的Lutx患者（36/54）开发为AKI，47％（17/36）患有AKI第1阶段，42％（15/36）AKI第2阶段，8％（3/36）严重艾基阶段3.肾表观扩散系数（ADCS）减少了AKI患者，但在没有AKI和健康志愿者的移植患者中（2.07±0.02 Vs 2.18±0.05 Vs 2.21±0.03×10 -3 mm 2 / s，P <.05）。与健康志愿者相比，所有LUTX受者都减少了扩散各向异性（AKI：0.27±0.01 VS NO AKI：0.28±0.01 VS健康：0.33±0.02; p <.01）。肾小血症的减少在Lutx后急性损失显着相关（术后术后术后肾功能和MRI当天的肾功能率）的急性损失。 MR扩散成像使得LUTX早期与AKI相关的肾变化的非侵入性评估。在Lutx之后的所有患者中存在扩散各向异性的减少，而仅在具有AKI的Lutx受者组中显着减少肾ADC并与肾功能损伤相关联。
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