Online ISSN: 2515-8260

Assessment of renal ADC values in normal and diabetic patients by DWI MRI sequence

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1Dr. Ashok Kumar Verma, 2Dr. Arbaz Zubair, 3Dr. Nimisha Mishra, 4Dr. Urousa Irfan


ABSTRACT Background: The term "diabetic nephropathy" refers to a clinical syndrome that includes persistent albuminuria, a consistent decrease in glomerular filtration rate (GFR) that eventually leads to end-stage renal disease, elevated arterial blood pressure, and increased cardiovascular morbidity and mortality. The apparent diffusion coefficient (ADC) has shown potential as a marker of renal function in several investigations, with decreased renal ADC in kidney disease. The aim of this study was to assess the difference in apparent diffusion coefficient (ADC) value in normal and diabetic kidney. Methods: This was a cross sectional analytical study conducted from January 2021 to October 2022 in in Department of Radio diagnosis with the help of Department of Medicine. The cases coming to the Department of Medicine for routine follow up fulfilling the inclusion (age >18 years of diabetes mellitus with history of diabetic nephropathy). The MRI examination was performed using a 3 Tesla system.Binary logistic regression analysis was used for estimating the parameters of a logistic model (the coefficients in the linear combination). The p-value was taken significant when less than 0.05 and confidence interval of 95% was taken. Results: In the study 26 (52%) cases were of diabetes mellitus while 24 (48%) cases were taken as control who were non diabetic. Out of 26 cases, majority belong to the stage 3 (46.2%) followed by the stage 4 and stage 5 with 6 (23.1%) cases each. The study included 1 case each of Stage 1 and stage 2. The ROC Analysis to find Accuracy of ADC Parameters for Detecting DM revealed that Lt, Rt and overall ADC values are highly accurate for detecting DM cases as their AUROC values comes out to be 0.999, 0.960 and 1.000 respectively, the very close/equal to perfect standard 1.000. Conclusion: The magnetic resonance imaging- Apparent diffusion Coefficient (ADC) value is an appropriate method for assessment and evaluation of diabetic nephropathy. Renal ADC values show a significant correlation with clinical stages of diabetic nephropathy, it is a reliable diagnostic tool for differentiation between diabetic nephropathy patients from diabetic patients without nephropathy.

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