الفهرس 
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Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disorder that almost involve all body organs. Lupus nephritis (LN) is clinically apparent in more than 50% of the patients with SLE, and it is histologically evident in most of lupus patients. LN is a major risk factor for morbidity and mortality in SLE.
Renal biopsy is indicated in any patient with SLE who has active urinary sediment or abnormal renal functions, especially upon the first attack of nephritis. However, it is an invasive procedure associated with many complications. Therefore, the identification of a non-invasive tool for assessing renal structure and function is vital. Magnetic resonance imaging (MRI) has the distinctive advantage of both structural and functional assessment. Techniques for functional renal imaging such as diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) have shown promising results in the assessment of renal functions.
The study was conducted to explore the association of diffusion DWI parameters as apparent diffusion coefficient (ADC) and fractional anisotropy (FA) with measurements of renal functions in a cohort of LN patients and to correlate these findings with renal histopathological changes, markers of activity and chronicity.
It was an observational cross-sectional study which was conducted on 60 subjects. Thirty patients diagnosed with LN representing the cases group and thirty healthy volunteers of matching age and sex representing the control group. Patients in the study group were adults diagnosed according to the Systemic Lupus International Collaborating Clinics (SLICC) criteria and they had evidence of renal involvement suggested by presence of active urinary sediment or impaired renal functions. Patients were subjected to full history taking, thorough physical examination and routine laboratory tests.
Renal biopsies were taken from the cases group within one week of the MRI. Each biopsy was routinely stained and classified according to the International Society of Nephrology (ISN) and the Renal Pathology Society (RPS) classification that was modified in 2018, also activity and chronicity indices were calculated. Assessment of renal fibrosis by 2 methods (trichrome and collagen III measurement by immunohistochemistry (IHC)) was done to improve the efficiency and reproducibility for better interpretation of renal fibrosis.