Keywords : apparent diffusion coefficient


Value of Apparent Diffusion Coefficient (ADC) in the Assessment of Renal Insufficiency in Diabetic Patients

Iraqi Postgraduate Medical Journal, 2019, Volume 18, Issue 3, Pages 197-203

BACKGROUND:
diabetic nephropathy is being recognized as a worldwide public problem with high cost and poor
outcomes, there is increase in the incidence and prevalence of renal failure all over the world.
Functional renal imaging methods such as diffusion- weighted magnetic resonance imaging (DWMRI),
has been shown to be a promising technique in the evaluation of renal function
OBJECTIVE:
To study the value of apparent diffusion coefficient (ADC) in the detection and evaluation of
diabetic nephropathy, correlating these values with the clinical stage of diabetic nephropathy and to
compare these findings with diabetic patient without nephropathy.
PAT IENTS AND METHODS:
A cross sectional analytic study was conducted in MRI unit of Radiology department at Al-Imamein
Al-Kadhimyain medical city through period form 1st oct.2017 to 30 of July 2018, 80 diabetic
patients were classified according to GFR into two groups; group I 40 patients (diabetic patient with
no nephropathy) group II 40 patients (diabetic patients with nephropathy). DWI ( b value ,0 and
1000 s/mm2) was performed in two group of the study . The mean ADC value of renal cortex was
calculated from three regions positioned in the upper, mid and lower third of the kidney.
The Relationship between ADC value and stage of diabetic nephropathy were assessed.
RESULTS:
In comparing diabetic patients (with no nephropathy) with patient with diabetic nephropathy, there
was significant decline in mean ADC value among patients with advanced stages of diabetic
nephropathy(p< 0.001). The mean ADC value with diabetic nephropathy was significantly lower
among patients with type I DM (P<0.001).
CONCLUSION:
The magnetic resonance imaging-apparent diffusion coefficient value is an appropriate method for
assessment and evaluation of diabetic nephropathy and is a reliable diagnostic tool for

The Role of Diffusion-Weighted MRI and Apparent Diffusion Coefficient in the Evaluation of Early Renal Allograft Dysfunction

Abdul Ameer A. Al-Mosawi; Raad H. Abed Tawfeq; Mustafa Rasool Hussein; Luma Khudayer Mohammad

Iraqi Postgraduate Medical Journal, 2017, Volume 16, Issue 1, Pages 35-40

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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