Features of Evaluating Renal Diffusion-Weighted Images and ASL-Perfusion Results in Acute Kidney Injury

Objective: to evaluate the features of renal diffusion-weighted images (DWI) and arterial spin labeling (ASL) perfusion results in acute kidney injury (AKI).

Material and methods. In the intensive care unit of Clinical Hospital No. 1 (Smolensk), 58 AKI patients were examined from 2021 to 2024. All patients underwent renal magnetic resonance imaging for 1–3 days with the inclusion of DWI sequences and ASL perfusion as well as ultrasound dopplerography. The control group was formed from 55 healthy volunteers to standardize the obtained results.

Results. The data were analyzed in comparison with AKI causal factor. The statistical results had cut-off thresholds that allowed predicting the cause of AKI, but a comprehensive analysis of the quantitative criterion of renal ASL perfusion, qualitative and quantitative criteria of DWI (r=0.947) was required. ASL perfusion indicators for all etiological causes were statistically significant in comparison with the normal ones (r=0.995). The determination of AKI causal factor was important for the subsequent management of patients: for a prerenal cause, active administration of plasma-substituting solutions, and for a renal one, restrictive infusion therapy tactics were needed. It was also noted that an increase in kidney ASL perfusion values had a positive effect on clinical and laboratory picture of AKI patients (r=0.903).

Conclusion. The feature of joint application of renal DWI and ASL perfusion in AKI is the comprehensive assessment of qualitative and quantitative criteria according to DWI data, and quantitative criterion according to ASL perfusion data. In assessing DWI, color mapping should be used. The complex results of renal DWI and ASL perfusion allow predicting AKI cause.

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