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

Abstract

BACKGROUND:diabetic nephropathy is being recognized as a worldwide public problem with high cost and pooroutcomes, 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 functionOBJECTIVE:To study the value of apparent diffusion coefficient (ADC) in the detection and evaluation ofdiabetic nephropathy, correlating these values with the clinical stage of diabetic nephropathy and tocompare 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-ImameinAl-Kadhimyain medical city through period form 1st oct.2017 to 30 of July 2018, 80 diabeticpatients were classified according to GFR into two groups; group I 40 patients (diabetic patient withno nephropathy) group II 40 patients (diabetic patients with nephropathy). DWI ( b value ,0 and1000 s/mm2) was performed in two group of the study . The mean ADC value of renal cortex wascalculated 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, therewas significant decline in mean ADC value among patients with advanced stages of diabeticnephropathy(p< 0.001). The mean ADC value with diabetic nephropathy was significantly loweramong patients with type I DM (P<0.001).CONCLUSION:The magnetic resonance imaging-apparent diffusion coefficient value is an appropriate method forassessment and evaluation of diabetic nephropathy and is a reliable diagnostic tool for