Evaluation of renal fibrosis in various causes of glomerulonephritis by MR elastography: a clinicopathologic comparative analysis


GÜVEN A. T. , İDİLMAN İ. S. , Cebrayilov C., ÖNAL C., ÜZERK KİBAR M., Saglam A., ...More

ABDOMINAL RADIOLOGY, 2021 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2021
  • Doi Number: 10.1007/s00261-021-03296-1
  • Journal Name: ABDOMINAL RADIOLOGY
  • Journal Indexes: Science Citation Index Expanded, Scopus
  • Keywords: Magnetic resonance imaging, Glomerulonephritis, Amyloidosis, Fibrosis, Kidney biopsy, MAGNETIC-RESONANCE ELASTOGRAPHY, APPARENT DIFFUSION-COEFFICIENT, KIDNEY FIBROSIS, ALLOGRAFT, DISEASE, BIOPSY, PATHOLOGY

Abstract

Background Renal parenchymal fibrosis is the most important determinant of kidney disease progression and it is determined via biopsy. The aim of this study is to evaluate the renal stiffness noninvasively by magnetic resonance elastography (MRE) and to compare it with clinicopathologic parameters in glomerulonephritis and AA amyloidosis patients. Methods Thirty-four patients with glomerular filtration rate (GFR) over 20 ml/min/1.73m(2) had non-contrast MRE prospectively. Kidney stiffness values were obtained from whole kidney, cortex, and medulla. Values were correlated with GFR, albuminuria, proteinuria, and degree of fibrosis that are assessed via renal biopsy. Patients were grouped clinicopathologically to assess the relation between stiffness and chronicity. Results Mean whole kidney, cortex, and medulla stiffnesses were 3.78 (+/- 1.26), 3.63 (+/- 1.25), and 4.77 (+/- 2.03) kPa, respectively. Mean global glomerulosclerosis was 22% (+/- 18%) and median segmental glomerulosclerosis was 4% (min-max: 0%-100%). Extent of tubulointerstitial fibrosis was less than 25% in 26 of the patients (76.5%), 25%-50% in 6 of the patients (17.6%), and higher than 50% in 2 of the patients (5.9%). Fourteen patients were defined to have chronic renal parenchymal injury. MRE-derived stiffness values correlated negatively with parameters of fibrosis. Lower stiffness values were observed in patients with chronic renal injury compared to those without (P < 0.05 for whole kidney and medulla MRE-derived stiffness). Conclusion MRE-derived stiffness values were lower in patients with chronic injury. Stiffness decreases as glomerulosclerosis and tubulointerstitial fibrosis progresses in patients with primary glomerulonephritis and AA amyloidosis. With future studies, there may be a role for MRE to assess renal function in concert with conventional markers.