الفهرس | Only 14 pages are availabe for public view |
Abstract Patients with chronic kidney disease (CKD) are at risk of a many of central nervous system complications such as stroke and cognitive impairment. Studies based on diffusion tensor imaging(DTI) confirmed that the integrity of white matter in CKD patients has changed and these alterations can be observed before tissue morphological changes occurring on conventional MRI. Early use of DTI in CKD patients can distinguish early individuals with normal cognitive system function and will develop cognitive impairment in later stages.In this study, we tried to highlight the clinical utility of DTI properties in qualitative and quantitative assessment of microstructural changes of the brain in chronic kidney disease patients This study was carried out at the MRI unit of radiology department at Urology and Nephrology center at Mansoura University between from May 2021 to May 2023 .It included 50 patients , The diseased group consists of 30 CKD patients who are either non-end-stage (NES-CKD) or end-stage renal disease (ESRD) patients without apparent neurological manifestations, whereas the control group consists of potential donors for renal transplantation. Changes of DTI parameters in different brain regions in CKD patients and control presents the hallmark in our study in addition to combined FA and MD showed better diagnostic accuracy between patient and control groups.DTI is an advanced MRI technique that was developed in the mid-1980s and can provide detailed information on the neuroanatomical integrity of the brain The microstructural organization of white matter tracts in the normal brain limits the degree of diffusion, resulting in lower MD/ADC values .However, due to changes in the white matter microstructure in CKD patients, this may be increased. This idea was made clear in this study, where the mean MD showed a statistically significant increase in the cases of CKD when compared to control subjects in various brain regions, with frontoparietal regions predominance In this study, the median FA demonstrated a statistically significant reduction in the cases with CKD in comparison with the control subjects in the following regions; fronto-parietal regions, genu of CC, anterior limb of internal capsules as well as caudate nuclei. While the median MD values were increased compared to controls in the following regions: corpus callosum including genu, body and splenium mainly, occipital and frontal regions . |