Evaluation of Renal Tubular Function by Multiparametric Functional MRI in Early Diabetes

Motivation: Accumulating evidence indicates that renal tubular injury, as a prime mover, plays an important role in the pathogenesis of diabetic kidney disease. Goal(s): We aimed to explore the tubular function in an alloxan-induced type 1 diabetic mellitus (DM) rabbit model using asymmetric spin echo (ASE), BOLD and ASL MRI with the furosemide diuretic test. Approach: We performed pairs of multiparametric MRIs (before and after furosemide injection) at baseline and 3/7 days post-DM, and scored pathological kidney injury. Results: We found that the pathological tubular injury scores in DM groups significantly correlated with medullary ΔR2* (post-furosemide – pre-furosemide difference) and oxygen extraction fraction (ΔOEF). Impact: The medullary ∆R2* and ∆OEF were closely related with pathological tubular injury. Our study demonstrated that the renal tubular dysfunction in early diabetes could be detected by the combination of asymmetric spin echo (ASE), BOLD and ASL MRI.