Non-invasive Assessment of Subclinical Renal Parenchymal Changes in Chronic Hepatitis B Virus By T1 Mapping Magnetic Resonance Imaging
Non-invasive Assessment of Subclinical Renal Parenchymal Changes in Chronic Hepatitis B Virus By T1 Mapping Magnetic Resonance Imaging
Background: Renal parenchymal changes are seen in chronic hepatitis B virus (HBV) infection, and its disease diagnosis should be confirmed by renal biopsy, which is an invasive technique. Apparent-T1 mapping magnetic resonance imaging (MRI) is an established imaging technique that assesses subclinical tissue injury without using a contrast agent. Aims: To investigate the early stage subclinical renal changes without apparent renal dysfunction in patients with chronic HBV infection by renal apparent-T1 mapping MRI. Study Design: A cross-sectional study. Methods: This study included 45 participants with normal kidney function, wherein 25 have biopsy-proven chronic HBV hepatitis and 20 are healthy individuals. Liver and kidney biochemical tests were performed within 1 month before the MRI scan, and the estimated glomerular filtration rate was calculated by diet modification in renal disease formula. Breath-hold, electrocardiogram-gated Modified Look-Locker Imaging sequence was acquired in the coronal plane without contrast agent administration. Apparent-T1 mapping value was measured by manually drawing a region of interest in six points for both kidneys by two observers. Apparent-T1 mapping values were compared between the two groups. Results: The mean apparent-T1 mapping values of the kidneys were significantly higher in patients with chronic HBV infection compared to the control group (1445 ± 129 ms vs. 1306 ± 115 ms, P = 0.003). Inter-class correlation coefficient measurement analysis showed excellent agreement. Conclusion: Renal apparent-T1 mapping MRI may help show the early stage of renal parenchymal disease without apparent renal dysfunction in chronic HBV infection.
___
- 1. Goldstein ST, Zhou F, Hadler SC, Bell BP, Mast EE, Margolis HS. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int J Epidemiol. 2005; 34:1329-1339. [Crossref]
- 2. Meuleman P, Libbrecht L, Wieland S, et al. Immune suppression uncovers endogenous cytopathic effects of the hepatitis B virus. J Virol. 2006;80:2797-807. [Crossref]
- 3. Apurva S, Deepak A. Spectrum of hepatitis B and renal involvement. Liver Int. 2018;38:23-32. [Crossref]
- 4. Bhimma R, Coovadia HM. Hepatitis B virus-associated nephropathy. Am J Nephrol. 2004;24:198-211. [Crossref]
- 5. Lai KN, Ho RT, Tam JS, Lai FM. Detection of hepatitis B virus DNA and RNA in kidneys of HBV related glomerulonephritis. Kidney Int. 1996;50:1965-1977. [Crossref]
- 6. Deng CL, Song XW, Liang HJ, Feng C, Sheng YJ, Wang MY. Chronic hepatitis B serum promotes apoptotic damage in human renal tubular cells. World J Gastroenterol. 2006;12:1752-6. [Crossref]
- 7. Lai KN, Li PK, Lui SF, et al. Membranous nephropathy related to hepatitis B virus in adults. N Engl J Med. 1991;324:1457-1463. [Crossref]
- 8. Jiang K, Ferguson CM, Lerman LO. Noninvasive assessment of renal fibrosis by magnetic resonance imaging and ultrasound techniques. Transl Res. 2019;209:105- 120. [Crossref]
- 9. Friedli I, Crowe LA, Berchtold L, et al. New magnetic resonance imaging index for renal fibrosis assessment: a comparison between diffusion-weighted imaging and T1 mapping with histological validation. Sci Rep. 2016;6:30088. [Crossref]
- 10. Beck-Tölly A, Eder M, Beitzke D, et al. Magnetic Resonance Imaging for Evaluation of Interstitial Fibrosis in Kidney Allografts. Transplant Direct. 2020;6:e577. [Crossref]
- 11. Cox EF, Buchanan CE, Bradley CR, et al. Multiparametric Renal Magnetic Resonance Imaging: Validation, Interventions, and Alterations in Chronic Kidney Disease. Front Physiol. 2017;8:696. [Crossref]
- 12. Rankin AJ, Allwood-Spiers S, Lee MMY, et al. Comparing the interobserver reproducibility of different regions of interest on multi-parametric renal magnetic resonance imaging in healthy volunteers, patients with heart failure and renal transplant recipients. MAGMA. 2020;33:103-112. [Crossref]
- 13. Gillis KA, McComb C, Patel RK, et al. Non-Contrast Renal Magnetic Resonance Imaging to Assess Perfusion and Corticomedullary Differentiation in Health and Chronic Kidney Disease. Nephron. 2016;133:183-192. [Crossref]
- 14. Wolf M, de Boer A, Sharma K, et al. Magnetic resonance imaging T1- and T2- mapping to assess renal structure and function: a systematic review and statement paper. Nephrol Dial Transplant. 2018;33:ii41-ii50. [Crossref]
- 15. Peperhove M, VoChieu VD, Jang MS, et al. Assessment of acute kidney injury with T1 mapping MRI following solid organ transplantation. Eur Radiol. 2018;28:44-50. [Crossref]
- 16. Rosmini S, Bulluck H, Abdel-Gadir A, et al. The Effect of Blood Composition on T1 Mapping. JACC Cardiovasc Imaging. 2019;12:1888-1890. [Crossref]
- 17. Jang E, Lee JK, Inn KS, Chung EK, Lee KT, Lee JH. Renal Dysfunction and Tubulopathy Induced by High-Dose Tenofovir Disoproxil Fumarate in C57BL/6 Mice. Healthcare (Basel). 2020;8:417. [Crossref]
- 18. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-174. [Crossref]
- 19. Lanzman RS, Wittsack HJ, Martirosian P, et al. Quantification of renal allograft perfusion using arterial spin labeling MRI: initial results. Eur Radiol. 2010;20:1485- 1491. [Crossref]
- 20. Prasad PV. Functional MRI of the kidney: tools for translational studies of pathophysiology of renal disease. Am J Physiol Ren Physiol. 2015;290:F958-974. [Crossref]
- 21. Pohlmann A, Hentschel J, Fechner M. High temporal resolution parametric MRI monitoring of the initial ischemia/reperfusion phase in experimental acute kidney injury. PLoS One. 2013;8:e57411. [Crossref]
- 22. Lanzman RS, Ljimani A, Pentang G, et al. Kidney transplant:functional assessment with diffusion-tensor MR imaging at 3T. Radiology. 2013;266:218-225. [Crossref]
- 23. Thoeny HC, De Keyzer F. Diffusion-weighted MR imaging of native and transplanted kidneys. Radiology. 2011;259:25-38. [Crossref]
- 24. Hueper K, Gutberlet M, Rodt T, et al. Diffusion tensor imaging and tractography for assessment of renal allograft dysfunction-initial results. Eur Radiol. 2011;21:2427- 2433. [Crossref]
- 25. Dekkers IA, de Boer A, Sharma K, et al. Consensus-based technical recommendations for clinical translation of renal T1 and T2 mapping MRI. MAGMA. 2020;33:163-176. [Crossref]
- 26. Graham-Brown MP, Singh A, Wormleighton J, et al. Association between native T1 mapping of the kidney and renal fibrosis in patients with IgA nephropathy. BMC Nephrology. 2019;20:256. [Crossref]
- 27. Hueper K, Peperhove M, RongS, et al. T1-mapping for assessment of ischemiainduced acute kidney injury and prediction of chronic kidney disease in mice. Eur Radiol. 2014;24:2252-2260. [Crossref]
- 28. Sheung-Fat K, Hon-Kan Yip, Yen-Yi Zhen, et al. Severe bilateral ischemic reperfusion renal injury: hyperacute and acute changes in apparent diffusion coefficient, T1, and T2 mapping with immunohistochemical correlations. Sci Rep. 2017;7:1725. [Crossref]
- 29. Genwen Hu, LiangW, Wu M, et al. Comparison of T1 Mapping and T1rho Values with Conventional Diffusion Weighted Imaging to Assess Fibrosis in a Rat Model of Unilateral Ureteral Obstruction. Acad Radiol. 2019;26:22-29. [Crossref]
- 30. FDA-NIH Biomarker Working Group. BEST (Biomarkers, EndpointS, and other Tools) Resource [Internet]. Silver Spring (MD): Food and Drug Administration (US); 2016-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK326791/ Copublished by National Institutes of Health (US), Bethesda (MD). [Crossref]
- 31. Radenkovic D, Weingärtner S, Ricketts L, et al. T1 mapping in cardiac MRI. Heart Fail Rev. 2017;22:415-430. [Crossref]
- 32. Huang Y, Sadowski EA, Artz NS, et al. Measurement and comparison of T1 relaxation times in native and transplanted kidney cortex and medulla. J Magn Reson Imaging. 2011;33:1241-1247. [Crossref]
- 33. Beck-Tölly A, Eder M, Beitzke D, et al. Magnetic Resonance Imaging for Evaluation of Interstitial Fibrosis in Kidney Allografts. Transplant Direct. 2020;15:e57vv7. [Crossref]