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Open AccessArticle

Multiparametric Assessment of Changes in Renal Tissue after Kidney Transplantation with Quantitative MR Relaxometry and Diffusion-Tensor Imaging at 3 T

1
Department of Radiology, Charité, Charitéplatz 1, 10117 Berlin, Germany
2
Department of Radiology, Charité, Hindenburgdamm 30, 12203 Berlin, Germany
3
Department of Nephrology, Charité, Charitéplatz 1, 10117 Berlin, Germany
4
Department of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, 81675 Munich, Germany
*
Authors to whom correspondence should be addressed.
These authors contributed equally.
J. Clin. Med. 2020, 9(5), 1551; https://doi.org/10.3390/jcm9051551
Received: 18 April 2020 / Revised: 15 May 2020 / Accepted: 18 May 2020 / Published: 21 May 2020
(This article belongs to the Special Issue Clinical Complications after Kidney Transplantation)
Background: Magnetic resonance relaxometry (MRR) offers highly reproducible pixel-wise parametric maps of T1 and T2 relaxation times, reflecting specific tissue properties, while diffusion-tensor imaging (DTI) is a promising technique for the characterization of microstructural changes, depending on the directionality of molecular motion. Both MMR and DTI may be used for non-invasive assessment of parenchymal changes caused by kidney injury or graft dysfunction. Methods: We examined 46 patients with kidney transplantation and 16 healthy controls, using T1/T2 relaxometry and DTI at 3 T. Twenty-two early transplants and 24 late transplants were included. Seven of the patients had prior renal biopsy (all of them dysfunctional allografts; 6/7 with tubular atrophy and 7/7 with interstitial fibrosis). Results: Compared to healthy controls, T1 and T2 relaxation times in the renal parenchyma were increased after transplantation, with the highest T1/T2 values in early transplants (T1: 1700 ± 53 ms/T2: 83 ± 6 ms compared to T1: 1514 ± 29 ms/T2: 78 ± 4 ms in controls). Medullary and cortical ADC/FA values were decreased in early transplants and highest in controls, with medullary FA values showing the most pronounced difference. Cortical renal T1, mean medullary FA and corticomedullary differentiation (CMD) values correlated best with renal function as measured by eGFR (cortical T1: r = −0.63, p < 0.001; medullary FA: r = 0.67, p < 0.001; FA CMD: r = 0.62, p < 0.001). Mean medullary FA proved to be a significant predictor for tubular atrophy (p < 0.001), while cortical T1 appeared as a significant predictor of interstitial fibrosis (p = 0.003). Conclusion: Cortical T1, medullary FA, and FA CMD might serve as new imaging biomarkers of renal function and histopathologic microstructure. View Full-Text
Keywords: transplantation; renal pathology; renal biopsy; multiparametric MRI; quantitative tissue analysis transplantation; renal pathology; renal biopsy; multiparametric MRI; quantitative tissue analysis
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Adams, L.C.; Bressem, K.K.; Scheibl, S.; Nunninger, M.; Gentsch, A.; Fahlenkamp, U.L.; Eckardt, K.-U.; Hamm, B.; Makowski, M.R. Multiparametric Assessment of Changes in Renal Tissue after Kidney Transplantation with Quantitative MR Relaxometry and Diffusion-Tensor Imaging at 3 T. J. Clin. Med. 2020, 9, 1551.

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