Using Multi-Model Diffusion Weighted Imaging to Study the Diagnostic Value and Severity of Acute Kidney Injury in Severe Acute Pancreatitis

Xinghui Li1#, Qi Liang2#, Zenghui Li1, Yong Li1, Yifan Ji1, Tianwu Chen1 and Xiao-Ming Zhang1*

1Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, China
2Department of Laboratory, Affiliated Hospital of North Sichuan Medical College, China
#These authors contributed equally to this work

^*Correspondance to: Xiao-Ming Zhang 

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Abstract:

Objective: To explore the diagnostic value and severity of Acute Kidney Injury (AKI) in patients with Severe Acute Pancreatitis (SAP) using Intravoxel Incoherent Motion Imaging (IVIM), Diffusion Tensor Imaging (DTI) and Diffusion Kurtosis Imaging (DKI). Methods: Fifty-six SAP patients were divided into an AKI group and a non-AKI group. All patients underwent routine abdominal, IVIM, DTI and DKI scans, and the main MRI parameters of kidney and clinical characteristics were measured. The diagnostic performance of AKI was compared, and the relationships among these indices, Glomerular Filtration Rate (eGFR) and AKI staging were analyzed. Finally, all parameters were analyzed by single- and multiparameter regression. Results: Compared with the non-AKI group, the percentage of CD3+ CD4+ T cells and CD4+/CD8+ ratio in peripheral blood increased significantly. The fast ADC value and Ff ADC value of the renal medulla in the AKI group were significantly lower than those in the non-AKI group. The FA value in the renal cortex was significantly lower than that in the medulla and significantly lower than that in the non-AKI group. The renal medulla MK value in the AKI group was significantly lower than that of the non-AKI group and had the best diagnostic value for AKI in SAP patients, which was positively correlated with AKI staging and negatively correlated with the eGFR. MK values, the percentage of CD3+ CD4+ T cells and CD4+/CD8+ ratio were independent risk factors for AKI by multiparameter logistic regression analysis. Conclusion: The measurement of renal DKI parameters combined with CD4+ T lymphocytes is practical for early diagnosis and predicting the severity of renal injury in SAP patients.

Keywords:

Acute severe pancreatitis; Acute kidney injury; Intravoxel incoherent motion
imaging; Diffusion tensor imaging; Diffusion kurtosis imaging

Cite the Article:

Li X, Liang Q, Li Z, Li Y, Ji Y, Chen T, et al. Using Multi-Model Diffusion Weighted Imaging to Study the Diagnostic Value and Severity of Acute Kidney Injury in Severe Acute Pancreatitis. Ann Clin Case Rep. 2021; 6: 2064..