Susanne Tewes MD, Presenter: Nothing to Disclose

Katja Hueper, Abstract Co-Author: Nothing to Disclose

Matti Peperhove MD, Abstract Co-Author: Nothing to Disclose

Bennet Johannes Ulrich Hensen, Abstract Co-Author: Nothing to Disclose

Mi-Sun Jang, Abstract Co-Author: Nothing to Disclose

Robert Greite, Abstract Co-Author: Nothing to Disclose

Marcus Hiss, Abstract Co-Author: Nothing to Disclose

Ralf Lichtinghagen MD, Abstract Co-Author: Nothing to Disclose

Bjoern Juettner, Abstract Co-Author: Nothing to Disclose

Gregor Warnecke, Abstract Co-Author: Nothing to Disclose

Christine Fegbeutel, Abstract Co-Author: Nothing to Disclose

Hermann Haller MD, Abstract Co-Author: Nothing to Disclose

Frank K. Wacker MD, Abstract Co-Author: Research Grant, Siemens AG Research Grant, Pro Medicus Limited

Dagmar Hartung MD, Abstract Co-Author: Nothing to Disclose

Faikah Gueler MD, Abstract Co-Author: Nothing to Disclose

Following lung transplantation (lutx) a majority of patients develop acute kidney injury (AKI), which is associated with an increased risk of chronic kidney disease (CKD) and poor outcome. Our purpose was to evaluate diffusion weighted imaging (DWI) for detection of AKI.

In the study 22 lutx patients and 9 age-matched healthy volunteers were included. Renal function was monitored by s-creatinine measurement, and presence and severity of AKI was diagnosed according to AKIN criteria. Patients underwent MRI 14±2 days after lutx using a 1.5 T magnet. A respiratory-triggered, fat-saturated echoplanar diffusion-weighted sequence was acquired with 10 b-values (b=0-1000 s/mm2). Maps of diffusion parameters were calculated using mono-exponential (ADCmono) and bi-exponential models (ADCd, ADCp, Fp). ROIs were placed manually into the upper, middle and lower third of renal cortex and medulla and mean±SD of diffusion parameters were calculated. MRI and clinical parameters were compared between groups using unpaired t-test and ANOVA.

77% (17/22) of lung transplant patients developed AKI (36% AKIN1 = mild, 32% AKIN2 = moderate, 9% AKIN3 = severe). Maximum s-creatinine was reached 1-2 days after lutx and it was significantly higher in AKI-patients compared to patients without AKI (156±70 vs 80±17 μmol/L, p<0.01). Pre-operative s-creatinine was normal in both groups. Mean age was not different when comparing patients with and without AKI (45±12 vs 55±6 y, p=0.10). ADCmono was significantly lower in patients with AKI compared to patients without AKI (cortex: 1.95±0.14 vs 2.19±0.04 x10-³ mm²/s, p<0.01; medulla: 2.01±0.15 vs 2.16±0.08 x10-³ mm²/s, p<0.05) and to healthy volunteers (cortex: 1.95±0.14 vs 2.16±0.16 x10-³ mm²/s, p<0.01; medulla: 2.01±0.15 vs 2.20±0.09 x10-³ mm²/s, p<0.01). No difference between patients without AKI and healthy subjects was observed. Similarly, cortical and medullary ADCd were significantly lower in AKI-patients than in controls (p<0.05, p<0.01). ADCp and Fp were not different.

DWI allows detection of AKI in the early period following lutx. It may also be useful as a biomarker to monitor renal function and to predict progression to CKD.

Early diagnosis of AKI is important to improve patient management and therapy monitoring in patients at risk of AKI. Functional MRI such as DWI enables assessment of renal function and pathology.  

Tewes, S, Hueper, K, Peperhove, M, Hensen, B, Jang, M, Greite, R, Hiss, M, Lichtinghagen, R, Juettner, B, Warnecke, G, Fegbeutel, C, Haller, H, Wacker, F, Hartung, D, Gueler, F, Assessment of Acute Kidney Injury in Patients after Lung Transplantation Using Diffusion Weighted Imaging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045577.html