Purpose or Case Report: Our aim is to evaluate the role of DWI sequence and ADC value measurement in the assessment of chronic kidney disease (CKD). Additionally, to estimate the relationship between changes of renal parenchyma ADC values and different stages of CKD
Methods & Materials: Over a nine months’ period, we prospectively evaluated 20 patients with CKD (group A: 7 females and 13 males), they are ranging in age from 2 to 18 years with the mean age of 10 ± 5.80 years. Ten healthy control of matching age were included (group B: 3 females and 7 males).
All patients with CKD were also examined by renal ultrasonography and color Doppler ultrasound for initial assessment or to clarify the diagnosis.
Routine MRI and axial DWI (b=600s/mm2) were performed in all patients. The ADC values of renal parenchyma in the two kidneys were measured. Three regions of interest (ROIs) of about 10mm2 were placed to the upper, the middle, the lower regions and calculating the average values.
Results: Causes of CKD include glomerulonephritis (n=9, 45%), hemolytic uremic syndrome (n=5, 25%), lupus nephritis (n=2, 10%), Nephronopathisis (n=2, 10%), infantile nephrosis (n=1, 5%), unknown (n=1, 5%). According to KIDGO guidelines patients with CDK were classified into 5 stages: (stage 1: n=6, 30%), stage 2 (n=4, 20%), stage 3 (n= 3, 15%), stage 4 (n=2, 10%), stage 5 (n= 5, 25%).
The mean ADC in group A (1.85X10-3 ±0.24) was lower than that of group B, (2.21X10-3 ± 0.12) with statistical significant difference (p value <0.00). There was a moderate negative correlation between stage of CKD and ADC with ‘r’ value of -.655 and a significant p value of <0.001.
Conclusions: MR DWI is an accurate and noninvasive method to evaluate children’s renal function. Quantitative DWI and ADC values may potentially play a role in the early diagnosis and staging of CKD as well as follow-up of disease progression.