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. 2024 Apr 3;24(1):78.
doi: 10.1186/s12880-024-01259-8.

Renal interstitial fibrotic assessment using non-Gaussian diffusion kurtosis imaging in a rat model of hyperuricemia

Ping-Kang Chen #  1 , Zhong-Yuan Cheng #  1 , Ya-Lin Wang  1 , Bao-Jun Xu  1 , Zong-Chao Yu  2 , Zhao-Xia Li  3 , Shang-Ao Gong  1 , Feng-Tao Zhang  4 , Long Qian  5 , Wei Cui  6 , You-Zhen Feng  7 , Xiang-Ran Cai  8
Affiliations

Renal interstitial fibrotic assessment using non-Gaussian diffusion kurtosis imaging in a rat model of hyperuricemia

Ping-Kang Chen et al. BMC Med Imaging. .

Abstract

Background: To investigate the feasibility of Diffusion Kurtosis Imaging (DKI) in assessing renal interstitial fibrosis induced by hyperuricemia.

Methods: A hyperuricemia rat model was established, and the rats were randomly split into the hyperuricemia (HUA), allopurinol (AP), and AP + empagliflozin (AP + EM) groups (n = 19 per group). Also, the normal rats were selected as controls (CON, n = 19). DKI was performed before treatment (baseline) and on days 1, 3, 5, 7, and 9 days after treatment. The DKI indicators, including mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD) of the cortex (CO), outer stripe of the outer medulla (OS), and inner stripe of the outer medulla (IS) were acquired. Additionally, hematoxylin and eosin (H&E) staining, Masson trichrome staining, and nuclear factor kappa B (NF-κB) immunostaining were used to reveal renal histopathological changes at baseline, 1, 5, and 9 days after treatment.

Results: The HUA, AP, and AP + EM group MKOS and MKIS values gradually increased during this study. The HUA group exhibited the highest MK value in outer medulla. Except for the CON group, all the groups showed a decreasing trend in the FA and MD values of outer medulla. The HUA group exhibited the lowest FA and MD values. The MKOS and MKIS values were positively correlated with Masson's trichrome staining results (r = 0.687, P < 0.001 and r = 0.604, P = 0.001, respectively). The MDOS and FAIS were negatively correlated with Masson's trichrome staining (r = -626, P < 0.0014 and r = -0.468, P = 0.01, respectively).

Conclusion: DKI may be a non-invasive method for monitoring renal interstitial fibrosis induced by hyperuricemia.

Keywords: Diffusion kurtosis imaging; Hyperuricemia; Magnetic resonance imaging; Renal interstitial fibrosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A T2 weighted image of kidney; B Regions of interest (ROI) into b = 0 s/mm2 image. From outside to inside: CO, cortex; OS, outer stripe of the outer medulla; and IS, inner stripe of the outer medulla
Fig. 2
Fig. 2
Parametric images of DKI. MK, mean kurtosis; FA, fractional anisotropy; MD, mean diffusivity in different time points; base, basement
Fig. 3
Fig. 3
The longitudinal changes of DKI parameters. *, were generated from comparisons between the four groups at each time point by using one-way analysis of variance. OS, outer stripe of outer medulla; IS, inner stripe of outer medulla; MK, mean kurtosis; FA, fractional anisotropy; MD, mean diffusivity; base, basement
Fig. 4
Fig. 4
The results of H&E staining. A Renal cortex, B Renal outer stripe of the renal outer medulla, and C Renal inner stripe of the renal outer medulla; 400 × magnification. A White arrow, normal renal glomerulus of cortex; B and C, the swollen tubular epithelial cells (black arrow), dilated renal tubules (yellow arrow), profile of inflammation cells in tubulointerstitial (red arrow), urate crystals in tubulointerstitial (green arrow), and pathological changes gradually aggravated over time; less severe renal tubular injury and declined infiltration of inflammation cells can be observed in the AP and AP + EM groups. CON, control; HUA, hyperuricemia; AP, allopurinol; AP + EM, allopurinol + empagliflozin; base, basement
Fig. 5
Fig. 5
A and B Renal interstitial fibrosis (black star) on Masson’s trichrome staining of OS and IS (400 × magnification.); C and D NF-κB expression (black arrow) on immunostaining of OS and IS (400 × magnification.). E and F The MOD of Masson trichrome staining different group in different time points of OS and IS (400 × magnification.). (G-H) The MOD of NF-κB immunostaining of different group in different time points of OS and IS (400 × magnification.). * generated from comparisons among the four groups at each time point using one-way ANOVA. OS, outer stripe of outer medulla; IS, inner stripe of outer medulla; HUA, hyperuricemia; AP, allopurinol; AP + EM, allopurinol + empagliflozin; NF-κB, nuclear factor kappa B; MOD, mean optical density
Fig. 6
Fig. 6
Correlational analyses of the MOD of Masson trichrome staining with DKI parameters. OS, outer stripe of outer medulla; IS, inner stripe of outer medulla; MK, mean kurtosis; FA, fractional anisotropy; MD, mean diffusivity; MOD, mean optical density
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