PMID- 37610209 OWN - NLM STAT- MEDLINE DCOM- 20240408 LR - 20240408 IS - 1522-2586 (Electronic) IS - 1053-1807 (Linking) VI - 59 IP - 5 DP - 2024 May TI - Assessment of the Added Value of Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging in Identifying Non-Diabetic Renal Disease in Patients With Type 2 Diabetes Mellitus. PG - 1593-1602 LID - 10.1002/jmri.28973 [doi] AB - BACKGROUND: Identification of non-diabetic renal disease (NDRD) in patients with type 2 diabetes mellitus (T2DM) may help tailor treatment. Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) is a promising tool to evaluate renal function but its potential role in the clinical differentiation between diabetic nephropathy (DN) and NDRD remains unclear. PURPOSE: To investigate the added role of IVIM-DWI in the differential diagnosis between DN and NDRD in patients with T2DM. STUDY TYPE: Prospective. POPULATION: Sixty-three patients with T2DM (ages: 22-69 years, 17 females) confirmed by renal biopsy divided into two subgroups (28 DN and 35 NDRD). FIELD STRENGTH/SEQUENCE: 3 T/ T2 weighted imaging (T(2)WI), and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI). ASSESSMENT: The parameters derived from IVIM-DWI (true diffusion coefficient [D], pseudo-diffusion coefficient [D*], and pseudo-diffusion fraction [f]) were calculated for the cortex and medulla, respectively. The clinical indexes related to renal function (eg cystatin C, etc.) and diabetes (eg diabetic retinopathy [DR], fasting blood glucose, etc.) were measured and calculated within 1 week before MRI scanning. The clinical model based on clinical indexes and the IVIM-based model based on IVIM parameters and clinical indexes were established and evaluated, respectively. STATISTICAL TESTS: Student's t-test; Mann-Whitney U test; Fisher's exact test; Chi-squared test; Intraclass correlation coefficient; Receiver operating characteristic analysis; Hosmer-Lemeshow test; DeLong's test. P < 0.05 was considered statistically significant. RESULTS: The cortex D*, DR, and cystatin C values were identified as independent predictors of NDRD in multivariable analysis. The IVIM-based model, comprising DR, cystatin C, and cortex D*, significantly outperformed the clinical model containing only DR, and cystatin C (AUC = 0.934, 0.845, respectively). DATA CONCLUSION: The IVIM parameters, especially the renal cortex D* value, might serve as novel indicators in the differential diagnosis between DN and NDRD in patients with T2DM. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2. CI - (c) 2023 International Society for Magnetic Resonance in Medicine. FAU - Zhou, Shao-Peng AU - Zhou SP AUID- ORCID: 0000-0002-4866-9550 AD - Medical School of Chinese PLA, Beijing, China. AD - Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Wang, Qian AU - Wang Q AUID- ORCID: 0000-0002-8366-6080 AD - Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China. FAU - Chen, Pu AU - Chen P AD - Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China. FAU - Zhai, Xue AU - Zhai X AD - Medical School of Chinese PLA, Beijing, China. AD - Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Zhao, Jian AU - Zhao J AUID- ORCID: 0000-0002-5125-1112 AD - Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Bai, Xu AU - Bai X AUID- ORCID: 0000-0001-8755-4257 AD - Medical School of Chinese PLA, Beijing, China. AD - Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Li, Lin AU - Li L AD - Hospital Management Institute, Department of Innovative Medical Research, Chinese PLA General Hospital, Beijing, China. FAU - Guo, Hui-Ping AU - Guo HP AUID- ORCID: 0000-0001-5197-871X AD - Medical School of Chinese PLA, Beijing, China. AD - Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Ning, Xue-Yi AU - Ning XY AD - Medical School of Chinese PLA, Beijing, China. AD - Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Zhang, Xiao-Jing AU - Zhang XJ AD - Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Ye, Hui-Yi AU - Ye HY AD - Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Dong, Zhe-Yi AU - Dong ZY AUID- ORCID: 0000-0001-7426-1666 AD - Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China. FAU - Chen, Xiang-Mei AU - Chen XM AD - Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China. FAU - Wang, Hai-Yi AU - Wang HY AUID- ORCID: 0000-0002-0717-1748 AD - Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China. LA - eng GR - 82271951/National Natural Science Foundation of China/ GR - 81700629/National Natural Science Foundation of China/ GR - Z221100007422121/Science & Technology Project of Beijing, China/ GR - 7222167/Beijing Natural Science Foundation/ PT - Journal Article DEP - 20230823 PL - United States TA - J Magn Reson Imaging JT - Journal of magnetic resonance imaging : JMRI JID - 9105850 RN - 0 (Cystatin C) SB - IM MH - Female MH - Humans MH - Young Adult MH - Adult MH - Middle Aged MH - Aged MH - *Diabetic Nephropathies/diagnostic imaging MH - Cystatin C MH - *Diabetes Mellitus, Type 2/complications/diagnostic imaging MH - Prospective Studies MH - Diffusion Magnetic Resonance Imaging/methods MH - Magnetic Resonance Imaging MH - Motion OTO - NOTNLM OT - diabetic nephropathy OT - intravoxel incoherent motion OT - non-diabetic renal disease OT - renal biopsy OT - type 2 diabetes mellitus EDAT- 2023/08/23 12:43 MHDA- 2024/04/08 06:43 CRDT- 2023/08/23 09:03 PHST- 2023/08/10 00:00 [revised] PHST- 2023/05/30 00:00 [received] PHST- 2023/08/10 00:00 [accepted] PHST- 2024/04/08 06:43 [medline] PHST- 2023/08/23 12:43 [pubmed] PHST- 2023/08/23 09:03 [entrez] AID - 10.1002/jmri.28973 [doi] PST - ppublish SO - J Magn Reson Imaging. 2024 May;59(5):1593-1602. doi: 10.1002/jmri.28973. Epub 2023 Aug 23.