Application value of native T1-mapping,DKI and BOLD-MRI in evaluating renal function in patients with IgA nephropathy
Objective:To investigate the application value of native T1-mapping,diffusion kurtosis imaging(DKI),and blood oxygenation level-dependent MRI(BOLD-MRI)in the evaluation of renal function in patients with IgA nephropathy(IgAN),and to compare the effectiveness of each MRI parameter.Methods:Fifty-seven IgAN patients diagnosed by biopsy and 19 healthy volunteers were included in this study.According to the severity of renal insufficiency,IgAN patients were divided into mild,moderate and severe impairment of renal function groups.MRI parameters were compared between healthy control group and IgAN group,as well as between each IgAN subgroup.To analyze the correlation between T1-mapping(T1),DKI(Fak,MK,MD),BOLD(R2*)and renal function evaluation indicators,such as estimated glomerular filtration rate(eGFR),serum crea-tinine(Scr)and cystatin C(CysC),explore and verify the application value of multiple renal MRI in evaluating renal function in IgAN patients.To compare the diagnostic performance of three types of magnetic resonance.Results:The difference of T1 value between control group and IgAN group was statistically significant[(1592.15±89.91)ms vs(1776.30±172.08)ms,P<0.001].There were significant differences in T1 values among different IgAN subgroup[mild(1684.86±103.57)ms,moderate(1888.99±182.01)ms,severe(1969.14±133.74)ms,all P<0.001].There was significant difference in Fak value between con-trol group and IgAN group[0.15(0.08-0.20)vs 0.19(0.11-0.32),P<0.05].There was significant difference in Fak value between mild and severe renal impairment groups[0.17(0.11-0.25)vs 0.35(0.28-0.40),P<0.01].There was no significant difference in R2*value among the groups.In IgAN group,T1 value was negatively correlated with eGFR(r=-0.620,P<0.001),hemoglobin(Hb)(r=-0.679,P<0.001),hematocrit(HCT)(r=-0.629,P<0.001),Scr(r=0.559,P<0.001),CysC(r=0.604,P<0.001).Fak was neg-atively correlated with eGFR(r=-4.004,P<0.05),and positively correlated with Scr(r=0.366,P<0.05)and CysC(r=0.378,P<0.01).MD was positively correlated with Hb(r=0.472,P<0.001)and HCT(r=0.498,P<0.001).There was no correlation between R2*value and clinical indicators.The AUC of T1 value for predicting mild,moderate and severe impairment of renal function in IgAN are 0.791(95%CI:0.660-0.922,P<0.01),0.972(95%CI:0.914-1.000,P<0.01)and 0.988(95%CI:0.958-1.000,P<0.01).The AUC of Fak value for predicting severe impairment of renal function in IgAN are 0.883(95%CI:0.678-1.000,P<0.01).Conclusion:Native T1-mapping and DKI are able to assese renal function in IgAN patients,and the predictive value of native T1-mapping is better than that of DKI.
immunoglobulin A nephropathyT1-mappingdiffusion kurtosis imagingblood oxygenation level-dependent magnetic resonance imagingmagnetic resonance imaging
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