Abstract

ABSTRACT:
BACKGROUND:
The most common complication of allografted kidney is renal allograft dysfunction which in some cases results in graft loss, the Diffusion Weighted-Magnetic Resonant Imaging (DW-MRI) and Apparent Diffusion Coefficient (ADC) value may provide a useful insight into the underlying pathology of renal allograft dysfunction.
OBJECTIVE:
To evaluate the utility and diagnostic performance of the DW-MRI and its ADC value in patients with early renal allograft dysfunction.
PATIENTS AND METHODS:
An analytic prospective study was conducted at MRI unit of Al Shaheed Ghazi Al Hariri Teaching Hospital from February 2015 to the end of November 2015, a total of 57 cases were included in this study, they divided in to two groups; control group: including 30 cases with stable or normal renal allograft function and patients group: including 27 cases with early renal allograft dysfunction. All study cases underwent DW-MRI with b value=1000 sec/mm2. The ADC was reconstructed and mean ADC values were correlated with histopathological biopsy results which is done for all patients group to determine the underlying etiology.
RESULTS:
The mean ADC values of the patients group (1.7±0.2) *10-3 mm2/s were significantly lower (p=0.001) compared with the mean ADC values in the control group (2.2±0.1) *10-3mm2/s. The cutoff ADC value between the control group and the patients group was (2.06*10-3 mm2/s). According to the morphological appearance in DWI and ADC map we can differentiate acute tubular necrosis (ATN) cases which expressed a heterogeneous appearance/mosaic pattern from acute renal allograft rejection cases and calcinurin inhibiter (CNI) nephrotoxicity cases where both expressed a homogenous morphological pattern.
CONCLUSION:
DW-MR and its ADC were valuable in the assessment of the underlying etiology of early renal allograft dysfunction and there was a Cutoff ADC value between stable or normal renal allograft function cases and early renal allograft dysfunction.
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