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Evaluation of renal allograft function early after transplantation with diffusion-weighted MR imaging

Eisenberger, Ute ; Thoeny, Harriet ; Binser, Tobias ; Gugger, Mathias ; Frey, Felix ; Boesch, Chris ; Vermathen, Peter

In: European Radiology, 2010, vol. 20, no. 6, p. 1374-1383

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    Title
    • Evaluation of renal allograft function early after transplantation with diffusion-weighted MR imaging
    Author
    • Eisenberger, Ute. Department of Nephrology and Hypertension, University Hospital of Bern, Bern, Switzerland
    • Thoeny, Harriet. Department of Radiology, Neuroradiology and Nuclear Medicine, University Hospital of Bern, Bern, Switzerland
    • Binser, Tobias. Department of Clinical Research, University Hospital of Bern, Bern, Switzerland
    • Gugger, Mathias. Department of Pathology, University Hospital of Bern, Bern, Switzerland
    • Frey, Felix. Department of Nephrology and Hypertension, University Hospital of Bern, Bern, Switzerland
    • Boesch, Chris. Department of Clinical Research, University Hospital of Bern, Bern, Switzerland
    • Vermathen, Peter. Department of Clinical Research, University Hospital of Bern, Bern, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:320306
    Summary
    Aims: To determine the inter-patient variability of apparent diffusion coefficients (ADC) and concurrent micro-circulation contributions from diffusion-weighted MR imaging (DW-MRI) in renal allografts early after transplantation, and to obtain initial information on whether these measures are altered in histologically proven acute allograft rejection (AR). Methods: DW-MRI was performed in 15 renal allograft recipients 5-19days after transplantation. Four patients presented with AR and one with acute tubular necrosis (ATN). Total ADC (ADCT) was determined, which includes diffusion and micro-circulation contributions. Furthermore, diffusion and micro-circulation contributions were separated, yielding the "perfusion fraction” (FP), and "perfusion-free” diffusion (ADCD). Results: Diffusion parameters in the ten allografts with stable function early after transplantation demonstrated low variabilities. Values for ADCT and ADCD were (×10−5mm2/s) 228 ± 14 and 203 ± 9, respectively, in cortex and 226 ± 16 and 199 ± 9, respectively, in medulla. FP values were 18 ± 5% in cortex and 19 ± 5% in medulla. FP values were strongly reduced to less than 12% in cortex and medulla of renal transplants with AR and ATN. FP values correlated with creatinine clearance. Conclusion: DW-MRI allows reliable determination of diffusion and micro-circulation contributions in renal allografts shortly after transplantation; deviations in AR indicate potential clinical utility of this method to non-invasively monitor derangements in renal allografts