Early Detection of Diabetic Nephropathy: The Added Value of Functional MRI | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 7, Volume 101, Issue 1, October 2025, Pages 4610-4619 PDF (1.02 M) | ||
| DOI: 10.21608/ejhm.2025.456369 | ||
| Abstract | ||
| Background: Diffusion Tensor Imaging (DTI) and renal tractography provide valuable insights into the microstructural organization of the kidney and enable the detection of alterations in diffusion parameters by quantifying fractional anisotropy (FA) and apparent diffusion coefficient (ADC). Objectives: This study aimed to evaluate whether advanced functional MRI techniques specifically, quantitative DTI metrics and renal fiber tractography can assist in the early detection of diabetic nephropathy. Patients and methods: Sixty patients with type 2 diabetes mellitus (DM) were enrolled in the study and categorized into two groups based on the presence of normoalbuminuria or microalbuminuria. In addition, a control group consisting of 20 age-matched healthy individuals without a history of diabetes was included for comparison. All participants, including patients and controls, underwent MRI scanning using a 1.5 Tesla GE Signa system. Results: Patients with microalbuminuria showed significantly lower cortical and medullary FA values and higher cortical ADC values. Tractography revealed reduced fiber count and disorganized tracts in this group. Cortical FA correlated positively with estimated glomerular filtration rate. (eGFR) and negatively with albuminuria, while ADC showed the opposite. Cortical FA demonstrated the highest diagnostic accuracy (AUC = 0.88) for detecting early renal microstructural changes. Conclusions: DTI and renal tractography effectively detect early renal microstructural changes in diabetic nephropathy. Cortical FA is a sensitive biomarker for early dysfunction, showing strong diagnostic performance and correlation with renal function and albuminuria. | ||
| Keywords | ||
| Diabetic nephropathy; Diffusion Tensor Imaging; FA; ADC | ||
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