Validation of multiparametric MRI by histopathology after nephrectomy: a case study
- PDF / 3,742,931 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 87 Downloads / 139 Views
RESEARCH ARTICLE
Validation of multiparametric MRI by histopathology after nephrectomy: a case study Anneloes de Boer1 · Tobias T. Pieters2 · Anita A. Harteveld1 · Peter J. Blankestijn2 · Clemens Bos1 · Martijn Froeling1 · Roel Goldschmeding3 · Hans J. M. Hoogduin1 · Jaap A. Joles2 · Bart‑Jeroen Petri4 · Marianne C. Verhaar2 · Tim Leiner1 · Tri Q. Nguyen3 · Arjan D. van Zuilen2 Received: 27 March 2020 / Revised: 23 July 2020 / Accepted: 1 September 2020 © The Author(s) 2020
Abstract Objectives Renal multiparametric MRI (mpMRI) is a promising tool to monitor renal allograft health to enable timely treatment of chronic allograft nephropathy. This study aims to validate mpMRI by whole-kidney histology following transplantectomy. Materials and methods A patient with kidney transplant failure underwent mpMRI prior to transplantectomy. The mpMRI included blood oxygenation level-dependent (BOLD) MRI, T1 and T2 mapping, diffusion-weighted imaging (DWI), 2D phase contrast (2DPC) and arterial spin labeling (ASL). Parenchymal mpMRI measures were compared to normative values obtained in 19 healthy controls. Differences were expressed in standard deviations (SD) of normative values. The mpMRI measures were compared qualitatively to histology. Results The mpMRI showed a heterogeneous parenchyma consistent with extensive interstitial hemorrhage on histology. A global increase in T1 (+ 3.0 SD) and restricted diffusivity (− 3.6 SD) were consistent with inflammation and fibrosis. Decreased T2 (− 1.8 SD) indicated fibrosis or hemorrhage. ASL showed diminished cortical perfusion (− 2.9 SD) with patent proximal arteries. 2DPC revealed a 69% decrease in renal perfusion. Histological evaluation showed a dense inflammatory infiltrate and fibrotic changes, consistent with mpMRI results. Most interlobular arteries were obliterated while proximal arteries were patent, consistent with ASL findings. Discussion mpMRI findings correlated well with histology both globally as well as locally. Keywords Multiparametric magnetic resonance imaging · Histology · Kidney · Kidney transplantation
Introduction Anneloes de Boer and Tobias Pieters contributed equally. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10334-020-00887-9) contains supplementary material, which is available to authorized users. * Anneloes de Boer a.deboer‑[email protected] 1
Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
2
Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
3
Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
4
Department of Vascular Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
Kidney transplantation is the treatment of choice for patients with end-stage kidney disease [1]. Close monitoring of the graft is crucial for early detection of treatable conditions [2]. Tr
Data Loading...
