Intravoxel incoherent motion (IVIM) at 3.0 T: evaluation of early renal function changes in type 2 diabetic patients.

PURPOSE: The purpose of this study was to evaluate the utility of intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI) parameters in identifying early renal function changes in diabetics.

METHODS: A total of 40 patients with type 2 diabetes mellitus and 20 healthy control subjects underwent multiple b value DWI. The diabetic patients were stratified into two groups based on albuminuria category: NAU (normal to mildly increased albuminuria; ACR < 30 mg/g) and MAU (moderately increased albuminuria; 30 ≤ ACR < 300 mg/g). The mean cortical and medullary IVIM parameters (D, D*, f, and ADC) were calculated and compared among the different groups, and the correlation of ACR and eGFR was also calculated.

RESULTS: The present study revealed the limited water molecule diffusion and hyperperfusion of renal cortex and medulla in diabetic patients before proteinuria detection. Mean cortical and medullary D values negatively correlated with the ACR values in diabetics with 30 ≤ ACR < 300 mg/g, whereas no correlation was found between ACR values and other IVIM parameters.

CONCLUSION: IVIM DWI might be helpful in noninvasively identifying early-stage DN. The IVIM parametric values are more sensitive than the ACR in detecting early-stage kidney changes.