The relationship of ADC values of renal parenchyma with CKD stage and serum creatinine levels

Eur J Radiol Open. 2015 Dec 9;3:8-11. doi: 10.1016/j.ejro.2015.10.002. eCollection 2016.

Abstract

Purpose: To evaluate the relationship of apparent diffusion coefficient (ADC) values of renal parenchyma with chronic kidney disease (CKD) stage and serum creatinine levels.

Materials and methods: One hundred and ten patients who had undergone magnetic resonance imaging of the upper abdomen for different reasons were retrospectively studied. A region of interest (ROI) was placed on the renal parenchyma for measurement of ADC values of both kidneys, without any preference for cortex or medulla. Three circular ROIs were placed-one each in the upper pole, interpolar region and lower pole of both kidneys. The mean ADC values were recorded for each patient and the relationship between ADC values and stage of CKD and serum creatinine levels were evaluated.

Results: Statistically significant difference was determined between the ADC values of the cases according to CKD stages (p < 0.001). Paired comparisons performed to determine the group that caused the difference revealed that median ADC values of healthy subjects who formed the control group was statistically significantly higher than that of the cases with stage 3, stage 4 and stage 5 CKD (p: 0.008; p: 0.008; and p: 0.002, respectively). Sensitivity and specificity were found to be 75.44% and 69.81%, respectively in detecting stage 3, stage 4 and stage 5 CKD among the cases with ADC values of 1151 and lower.

Conclusion: ADC values can play a role in the evaluation of renal dysfunction. However, population-and protocol-based cut-off ADC values are needed to identify renal dysfunction and to distinguish between different stages of CKD.

Keywords: ADC; Chronic kidney disease; MRI.