Diffusion-weighted imaging and pathology of chronic kidney disease: initial study

Purpose To investigate the value of diffusion-weighted imaging (DWI) for assessing histopathologic changes observed in chronic kidney disease (CKD). Methods Fifty-two patients with CKD underwent DWI before renal biopsy. The renal apparent diffusion coefficient (ADC) values and histopathologic changes were analyzed. The pathologic changes were scored using a semi-quantitative method (no lesion as 0, mild lesion as 1, moderate lesion as 2, and severe lesion as 3). The relationships between renal histopathologic scores, types, classification, and right renal ADCs were analyzed using ANOVA and Pearson’s or Spearman’s correlation tests. Results Negative correlations were found between the right renal ADCs and scores of tubulointerstitial lesions ( r = − 0.354, P = 0.012), the severity of tubular atrophy ( r = − 0.439, P = 0.002), and the severity of interstitial fibrosis ( r = − 0.272, P = 0.049). There were no correlations between the ADCs and scores of glomeruli and peritubular vessel lesions ( P > 0.05). There were significant differences among groups based on pathology types ( P = 0.009). There was no significant relationship between renal ADCs and the pathologic classification ( P > 0.05). Conclusions DWI may be helpful to detect tubulointerstitial injury, including tubular atrophy and interstitial fibrosis. DWI may have the potential to serve as an effective auxiliary method to help nephrologists to evaluate patients with CKD.