The assessment of early CKD damage is of crucial importance in preventing CKD-induced diseases (13). In this study, we investigated the diagnostic efficacy of DTI-GBMRI in evaluating histopathology and renal efficiency in patients with in CKD patients. Functional parameters associated with renal impairment in kidney function were analyzed in DTI-GBMRI-diagnosed CKD patients with CKD. Findings in this study found DTI-GBMRI accurately imaged the pathological characteristics and depict renal efficiency in CKD patients. Thus, DTI-GBMRI may be a potential noninvasive method for measuring renal function for CKD patients.
CKD has been associated with increased visual impairment and cardiovascular disease (13). Inflammation and dysfunction of glomerular cells contributes to the cardiovascular disease burden associated with CKD, which is one of the most important risk factors for mortality and morbidity in CKD patients (14). Thus, it is very important to evaluate the degree of CKD and analyze abnormalities of kidney structure or function (15). MRI methods have become available for renal functional evaluation for patients with CKD, which can access renal function combined with high-resolution morphological evaluation of the kidneys and the entire urinary tract (16). In this study, we found that DTI-GBMRI presented higher efficacy in evaluating renal histopathology and renal efficiency, renal fibrosis and damage, noninvasive quantification of renal blood flow than DTI-MRI. Data reported that DTI-GBMRI clearly showed the diameters of lesions, good performance in measuring lumen depiction scores, intraluminal signal homogeneity, and CNR efficiency in CKD patients compared to DTI-MRI, suggesting DTI-GBMRI provided the possible origins of differences in estimates of CKD prevalence, and presented possible solutions for tackling the factors responsible for the reported variations in renal injury measurements.
Previously, MRI allows the assessment of markers of perfusion without the use of contrast media (17). A study highlighted the potential clinical benefits of early detection in patients predisposed to CKD by using MRI techniques, which provided structural and functional information in the kidney (7). Zhao et al found that diffusion-weighted MRI can be used to assess renal fibrosis in CKD patients (18). Data in this study observed that DTI-GBMRI-diagnosed CDK patients had higher MTTK, stronger impairment of renal perfusion and more pronounced increases in T2 and T1 relaxation times than DTI-MRI in CKD patients. However, there was no significant difference in evaluating kidney volumes between DTI-GBMRI and DTI-MRI groups. A previous study demonstrated that MRI could classify renal function, identify eGFR and functional renal parenchyma RBF in CKD patients (18, 19). Findings in the current study demonstrated that DTI-GBMRI-diagnosed CKD patients showed lower cortical RBF values and eGFR than those patients diagnosed by DTI-MRI.
MRI method has been used in diagnosing CKD for it is a noninvasive and accessible method (20–22). However, its operator dependency and low sensitivity reduce its utility in research. This study introduced gadolinium-based MRI to improve operator dependency and low sensitivity in diagnosing cortical RBFs eGFR, renal fibrosis, renal damage and eGFR in CKD patients. The strategies of this study compared the diagnostic efficacy between DTI-GBMRI and DTI-MRI, and outcomes found that DTI-GBMRI method showed the superior diagnostic accuracy, sensitivity and specificity compared to DTI-MRI in patients with CKD.