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Background <p>Early diagnosis and treatment of diabetic nephropathy (DN) is important for improving prognosis of patients, but the noninvasive and reliable diagnostic tool is lacking. We aim to investigate the ability of multiparametric MRI for detecting early DN in high-risk patients with type 2 diabetes.</p> Methods <p>Between June 2023 and October 2024, we prospectively recruited 80 patients(diabetic patients group, <i>n</i> = 42, 53.4 ± 10.0 years old; DN patients group, <i>n</i> = 38, 47.9 ± 10.9 years old) and 16 healthy volunteers(control group, 49.5 ± 9.5 years old). All participants were examined using multiparametric MRI(IVIM, DKI, ASL and T1 mapping). The true diffusion coefficient(D), perfusion fraction(f), mean diffusivity(MD), mean kurtosis(MK), renal blood flow(RBF), T1 values in renal cortex were measured. Renal cortical MRI parameters among 3 groups were compared by one-way analysis of variance. Correlation between estimated glomerular filtration rate(eGFR), 24-hour urine albumin(24&#xa0;h-UA) and renal cortical MRI parameters was evaluated using Spearman correlation analysis. The diagnostic performances of MRI parameters compared with biochemical indexes for detecting early DN were assessed using receiver operating characteristic curves.</p> Results <p>Renal cortical MRI parameters demonstrated statistically significant differences among 3 groups(<i>P</i> &lt; 0.050). The eGFR, 24&#xa0;h-UA significantly correlated with renal cortical MRI parameters(<i>P</i> &lt; 0. 001). The areas under the curve(AUCs) for discriminating diabetic patients group from DN patients group were 0.706, 0.864, 0.732, 0.718, 0.910 and 0.718 for D, f, MD, MK, RBF and T1 values. AUCs of renal cortical f, RBF values were significantly larger than that of eGFR, serum creatinine, 24&#xa0;h-UA, fasting blood glucose(<i>P</i> &lt; 0.050).</p> Conclusions <p>Intravoxel incoherent motion diffusion-weighted imaging and arterial spin labeling exhibited considerable promise as noninvasive tools for detecting DN in high-risk patients with type 2 diabetes.</p>

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Capability of multiparametric MRI to detect diabetic nephropathy in high-risk patients with type 2 diabetes: a prospective preliminary study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月20日

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  • Wei Mao,
  • Xiaoqiang Ding,
  • Caixia Fu,
  • Bernd Kuehn,
  • Dominik Nickel,
  • Robert Grimm,
  • Thomas Benkert,
  • Mengsu Zeng,
  • Jianjun Zhou

摘要

Background

Early diagnosis and treatment of diabetic nephropathy (DN) is important for improving prognosis of patients, but the noninvasive and reliable diagnostic tool is lacking. We aim to investigate the ability of multiparametric MRI for detecting early DN in high-risk patients with type 2 diabetes.

Methods

Between June 2023 and October 2024, we prospectively recruited 80 patients(diabetic patients group, n = 42, 53.4 ± 10.0 years old; DN patients group, n = 38, 47.9 ± 10.9 years old) and 16 healthy volunteers(control group, 49.5 ± 9.5 years old). All participants were examined using multiparametric MRI(IVIM, DKI, ASL and T1 mapping). The true diffusion coefficient(D), perfusion fraction(f), mean diffusivity(MD), mean kurtosis(MK), renal blood flow(RBF), T1 values in renal cortex were measured. Renal cortical MRI parameters among 3 groups were compared by one-way analysis of variance. Correlation between estimated glomerular filtration rate(eGFR), 24-hour urine albumin(24 h-UA) and renal cortical MRI parameters was evaluated using Spearman correlation analysis. The diagnostic performances of MRI parameters compared with biochemical indexes for detecting early DN were assessed using receiver operating characteristic curves.

Results

Renal cortical MRI parameters demonstrated statistically significant differences among 3 groups(P < 0.050). The eGFR, 24 h-UA significantly correlated with renal cortical MRI parameters(P < 0. 001). The areas under the curve(AUCs) for discriminating diabetic patients group from DN patients group were 0.706, 0.864, 0.732, 0.718, 0.910 and 0.718 for D, f, MD, MK, RBF and T1 values. AUCs of renal cortical f, RBF values were significantly larger than that of eGFR, serum creatinine, 24 h-UA, fasting blood glucose(P < 0.050).

Conclusions

Intravoxel incoherent motion diffusion-weighted imaging and arterial spin labeling exhibited considerable promise as noninvasive tools for detecting DN in high-risk patients with type 2 diabetes.