# Early Diagnosis of Acute Rejection and Acute Tubular Necrosis After Kidney Transplantation Using Magnetic Resonance Imaging: Evaluation of the Diffusion-Weighted Imaging Method

## TL;DR

This study shows that diffusion-weighted MRI can help detect early kidney transplant complications like acute rejection and acute tubular necrosis.

## Contribution

The study demonstrates the potential of diffusion-weighted imaging as a non-invasive method for early detection of kidney transplant complications.

## Key findings

- Lower ADC values were observed in patients with acute rejection or acute tubular necrosis.
- Significant differences in ADC values were found in all kidney regions between the study and control groups.

## Abstract

Introduction

Complications such as acute rejection (AR) and acute tubular necrosis (ATN) following kidney transplantation can adversely affect graft function, complicating the treatment process and endangering patient health. Diffusion-weighted magnetic resonance imaging (DWI) has emerged as a promising imaging modality for detecting microscopic changes in renal tissue, particularly those affecting cellular structures. This study aims to evaluate the potential of DWI in detecting AR and ATN in kidney transplant patients.

Methods

A total of 24 patients who underwent kidney transplantation at the Department of Organ Transplantation, Ege University Faculty of Medicine, between January 2010 and December 2019 were included in the study. Fourteen patients with AR or ATN formed the study group, while the remaining 10 patients, who did not develop complications, constituted the control group. All patients underwent DWI using a 3 Tesla magnetic resonance imaging (MRI) device, and apparent diffusion coefficient (ADC) values were measured at different levels of the renal cortex and medulla.

Results

When evaluating the mean ADC values (×10⁻³ mm²/second) measured from the upper, middle, and lower poles of the kidneys, significantly lower values were observed in the study group compared to the control group. Statistically significant differences were found in all regions (p < 0.05).

Conclusion

In conclusion, this study highlights the potential utility of DWI as a non-invasive tool for assessing renal allograft function and detecting early graft injury in kidney transplant recipients.