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Clinical Article
Quantitative measurement of renal fat in patients with type 2 diabetes mellitus: Comparison between Dixon and HISTO MRS techniques
LI Yi  XIE Lianghua  LIU Liu  ZHAO Xiaofang  YANG Ping  TANG Huali  MAO Yun 

LI Y, XIE L H, LIU L, et al. Quantitative measurement of renal fat in patients with type 2 diabetes mellitus: Comparison between Dixon and HISTO MRS techniques[J]. Chin J Magn Reson Imaging, 2023, 14(9): 86-91. DOI:10.12015/issn.1674-8034.2023.09.015.

[Abstract] Objective To compare the concordance of renal fat quantification measures based on the six-echo water-fat separation (Dixon) and high-speed T2-corrected multiecho magnetic resonance spectroscopic (HISTO MRS) techniques, and to investigate their predictive ability for renal function impairment. Provide a basis for determining the extent of renal lipotoxicity in patients with type 2 diabetes mellitus (T2DM) and for monitoring treatment efficacy.Materials and Methods This prospective study enrolled 172 patients with T2DM and 55 healthy subjects. Renal proton density fat fraction (PDFF) was obtained through abdominal 3 T MRI using Dixon and HISTO MRS techniques, recorded as D-PDFF and H-PDFF. The intraclass correlation coefficient was used to evaluate the consistency between the two techniques within the same group. The subjects were divided into healthy subjects, normal renal function group in T2DM patients (N-T2DM), mild to moderate renal function impairment group in T2DM patients (M-T2DM), and severe renal function impairment group in T2DM patients (S-T2DM) based on the presence or absence of T2DM and estimated glomerular filtration rate (eGFR), and inter-group differences were compared. Pearson correlation and multiple linear regression analyses were performed to investigate whether D-PDFF and H-PDFF are independent risk factors for decreased eGFR.Results The interclass correlation coefficient was 0.185 for D-PDFF and H-PDFF. After adjusting for confounding factors, the difference in D-PDFF between healthy participants and T2DM patients was statistically significant (P<0.001), while the difference in H-PDFF was not statistically significant (P>0.05). After adjustment, the differences in D-PDFF between the healthy participant group and the N-T2DM group, the healthy participant group and the M-T2DM group, and the N-T2DM group and the M-T2DM group were all statistically significant (all P≤0.001). The differences in H-PDFF among the groups were not statistically significant (all P>0.05). D-PDFF was independently and negatively associated with increased eGFR (β=-0.168, P=0.016) after correction for confounders and was identified as an independent risk factor for renal impairment. H-PDFF values did not correlate with eGFR (β=-0.008, P=0.918).Conclusions The two magnetic resonance fat quantification techniques are poorly concordant in the kidney. Dixon-based PDFF is more responsive to increased renal ectopic fat accumulation (RELA) and renal function impairment in patients with T2DM than HISTO MRS-based PDFF. Therefore, Dixon-based PDFF may be a more suitable method for monitoring RELA in patients with T2DM.
[Keywords] diabetes mellitus, type 2;diabetic nephropathies;lipid accumulation;renal lipotoxicity;renal function;quantitative measurement of fat;magnetic resonance imaging

LI Yi   XIE Lianghua   LIU Liu   ZHAO Xiaofang   YANG Ping   TANG Huali   MAO Yun*  

Department of Radiology, the First Hospital of Chongqing Medical University, Chongqing 404100, China

Corresponding author: Mao Y, E-mail:

Conflicts of interest   None.

Received  2023-04-11
Accepted  2023-08-09
DOI: 10.12015/issn.1674-8034.2023.09.015
LI Y, XIE L H, LIU L, et al. Quantitative measurement of renal fat in patients with type 2 diabetes mellitus: Comparison between Dixon and HISTO MRS techniques[J]. Chin J Magn Reson Imaging, 2023, 14(9): 86-91. DOI:10.12015/issn.1674-8034.2023.09.015.

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