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Objective <p>To investigate the utility of intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) for early detection of renal injury 24 h after cardiac arrest and cardiopulmonary resuscitation.</p> Materials and methods <p>Twenty-four male Sprague–Dawley rats were randomized into cardiac arrest (<i>n</i> = 15) and sham-operated (<i>n</i> = 9) groups. Five cardiac arrest rats died during the procedure, resulting in 10 cardiac arrest and 9 sham rats for analysis. IVIM-MRI and renal parameters were assessed 24 h after cardiac arrest and cardiopulmonary resuscitation. Diffusion-related parameters, including apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), and exponential ADC (eADC), were obtained. The primary imaging endpoint was defined as D. Following completion of MRI, renal function, histopathology, and expression of apoptosis markers (Bcl-2, Caspase-3), water channel protein aquaporin-3, and tight junction proteins (zonula occludens-1, occludin) were subsequently evaluated.</p> Results <p>Despite preserved conventional renal function, IVIM MRI detected early renal alterations 24 h after cardiac arrest. Compared with the sham group, eADC, D, ADC, D*, and f values were all significantly reduced. Histopathological analysis revealed pronounced tubular epithelial injury, increased apoptosis (Bcl-2, <i>p</i> &lt; 0.001; Caspase-3, <i>p</i> = 0.010), and reduced expression of aquaporin-3 (<i>p</i> = 0.039), zonula occludens-1 (<i>p</i> &lt; 0.001), and occludin (<i>p</i> &lt; 0.001).</p> Conclusion <p>IVIM MRI enables early, noninvasive detection of renal injury 24 h after cardiac arrest and CPR, reflecting tubular injury, tight junction disruption, and perfusion deficits, potentially facilitating timely intervention and improving prognosis.</p> Relevance statement <p>This approach may facilitate individualized therapy and improve post-cardiac arrest syndrome outcome.</p> Key Points <p><UnorderedList Mark="Bullet"> <ItemContent> <p>The long-term outcomes of cardiac arrest remain poor due to post-cardiac arrest syndrome.</p> </ItemContent> <ItemContent> <p>IVIM MRI enables early, noninvasive detection of renal injury after cardiac arrest and cardiopulmonary resuscitation.</p> </ItemContent> <ItemContent> <p>This approach may facilitate individualized therapy and improve post-cardiac arrest syndrome.</p> </ItemContent> </UnorderedList></p> Graphical Abstract <p></p>

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Intravoxel incoherent motion MRI for early detection and assessment of renal injury after cardiac arrest and resuscitation in a rat model

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月13日

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  • Jie Zhang,
  • Na Zhan,
  • Haoyi Ye,
  • Siqi Liu,
  • Yunke Tan,
  • Jinzhao Zhang,
  • Teng Huang,
  • Zhihua Wu,
  • Zhengfei Yang,
  • Zhifeng Liu

摘要

Objective

To investigate the utility of intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) for early detection of renal injury 24 h after cardiac arrest and cardiopulmonary resuscitation.

Materials and methods

Twenty-four male Sprague–Dawley rats were randomized into cardiac arrest (n = 15) and sham-operated (n = 9) groups. Five cardiac arrest rats died during the procedure, resulting in 10 cardiac arrest and 9 sham rats for analysis. IVIM-MRI and renal parameters were assessed 24 h after cardiac arrest and cardiopulmonary resuscitation. Diffusion-related parameters, including apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), and exponential ADC (eADC), were obtained. The primary imaging endpoint was defined as D. Following completion of MRI, renal function, histopathology, and expression of apoptosis markers (Bcl-2, Caspase-3), water channel protein aquaporin-3, and tight junction proteins (zonula occludens-1, occludin) were subsequently evaluated.

Results

Despite preserved conventional renal function, IVIM MRI detected early renal alterations 24 h after cardiac arrest. Compared with the sham group, eADC, D, ADC, D*, and f values were all significantly reduced. Histopathological analysis revealed pronounced tubular epithelial injury, increased apoptosis (Bcl-2, p < 0.001; Caspase-3, p = 0.010), and reduced expression of aquaporin-3 (p = 0.039), zonula occludens-1 (p < 0.001), and occludin (p < 0.001).

Conclusion

IVIM MRI enables early, noninvasive detection of renal injury 24 h after cardiac arrest and CPR, reflecting tubular injury, tight junction disruption, and perfusion deficits, potentially facilitating timely intervention and improving prognosis.

Relevance statement

This approach may facilitate individualized therapy and improve post-cardiac arrest syndrome outcome.

Key Points

The long-term outcomes of cardiac arrest remain poor due to post-cardiac arrest syndrome.

IVIM MRI enables early, noninvasive detection of renal injury after cardiac arrest and cardiopulmonary resuscitation.

This approach may facilitate individualized therapy and improve post-cardiac arrest syndrome.

Graphical Abstract