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DTI of the kidney in children: comparison between normal kidneys and those with ureteropelvic junction (UPJ) obstruction.
Magnetic Resonance Materials in Physics Biology and Medicine ( IF 2.3 ) Pub Date : 2019-12-16 , DOI: 10.1007/s10334-019-00812-9
Hansel J Otero 1 , Juan S Calle-Toro 1 , Carolina L Maya 1 , Kassa Darge 1 , Suraj D Serai 1
Affiliation  

OBJECTIVE To compare renal diffusion tensor imaging (DTI) parameters in patients with or without ureteropelvic junction (UPJ) obstruction. METHODS Patients that underwent functional MR urography (MRU) with renal DTI were retrospectively selected. Kidneys deemed normal on T2-weighted images and functional parameters were used as controls and compared to those kidneys with morphologic and functional findings of UPJ obstruction. DTI included a 20-direction DTI with b values of b = 0 s/mm2 and b = 400 s/mm2. Diffusion Toolkit was used for analysis and segmentation. TrackVis was used to draw regions of interest (ROI) covering the entire volume of the renal parenchyma, excluding the collecting system. Fibers were reconstructed using a deterministic fiber tracking algorithm. Whole kidney ROI-based analysis was performed to obtain cortico-medullary measurements (FA, ADC and track length) for each kidney. T tests were performed to compare means and statistical significance was defined at p < 0.05. RESULTS 118 normal kidneys from 102 patients (median age 7 years, IQR 6-15 years; 58 males and 44 females) were compared to 22 kidneys from 16 patients (median age 13 years, IQR 3-15 years; 9 males and 7 females) with UPJ obstruction. Mean FA values were significantly lower (0.31 ± 0.07; n = 22) in kidneys with UPJ obstruction than normal kidneys (0.40 ± 0.08; n = 118) (p < 0.001). ADC was marginally significantly increased (p = 0.01) and track length was not significantly different (p = 0.24). CONCLUSION Our results suggest that DTI-derived metrics including FA and ADC are potential biomarkers to differentiate kidneys with UPJ obstruction and assess renal parenchymal damage.

中文翻译:

儿童肾脏的DTI:正常肾脏与输尿管盆腔连接(UPJ)阻塞的肾脏之间的比较。

目的比较患有或不患有输尿管盆腔连接(UPJ)梗阻的患者的肾脏扩散张量成像(DTI)参数。方法回顾性选择接受肾DTI的功能性MR尿路造影(MRU)的患者。将在T2加权图像和功能参数上被认为正常的肾脏用作对照,并与那些形态学和功能发现UPJ梗阻的肾脏进行比较。DTI包括一个20方向DTI,其b值为b = 0 s / mm2和b = 400 s / mm2。扩散工具包用于分析和细分。TrackVis用于绘制覆盖肾脏实质的整个体积(不包括收集系统)的感兴趣区域(ROI)。使用确定性纤维跟踪算法重建纤维。进行基于全肾ROI的分析,以获取每个肾脏的皮质髓质测量值(FA,ADC和轨迹长度)。进行了T检验以比较均值,并且统计显着性定义为p <0.05。结果比较了102例患者(中位年龄7岁,IQR 6-15岁;男性58例,女性44例)的118例正常肾脏,将16例患者(中值年龄13岁,IQR 3-15岁的男性22例肾脏)进行了比较;男性9例,女性7例)与UPJ阻塞。UPJ梗阻肾脏的平均FA值显着低于正常肾脏(0.40±0.08; n = 118)(0.31±0.07; n = 22)(p <0.001)。ADC略有增加(p = 0.01),走线长度也没有显着差异(p = 0.24)。
更新日期:2019-12-16
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