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Diffusion\u2010relaxation correlated spectrum imaging (DR\u2010CSI) has previously been applied to assess renal fibrosis, yet current approaches for compartment identification lack quantified standards. Purpose: This exploratory study is aimed at establishing a spectrum\u2010pathology correlation analysis for identifying possible DR\u2010CSI compartments, and explore the diagnostic value of the compartment fractions on common pathologic features.<\/jats:p><\/jats:sec>Study Type<\/jats:title>Cross\u2010sectional.<\/jats:p><\/jats:sec>Population\/Subjects<\/jats:title>66 LN patients (58 females) and 20 healthy volunteers (17 females).<\/jats:p><\/jats:sec>Field Strength\/Sequence<\/jats:title>3\u2009T scanner\/Axial renal DR\u2010CSI scan with 34 contrasts (TE 55~170\u2009ms, b\u2010values 0~1200\u2009s\/mm2<\/jats:sup>).<\/jats:p><\/jats:sec>Assessment<\/jats:title>Pathologic classification, activity index, and chronicity index were obtained through biopsy. The estimated glomerular filtration rate (eGFR) was assessed, representing renal function. Four compartments, short\u2010T2 (S), restricted\u2010diffusion (R), long\u2010T2 (L), and pseudo\u2010diffusion (PD), were identified. Compartment fractions F<\/jats:italic>\nX<\/jats:sub> were calculated (X: compartment label).<\/jats:p><\/jats:sec>Statistical Tests<\/jats:title>Spearman correlation for spectrum\u2010pathology relationship. Student's t<\/jats:italic>\u2010test or Mann\u2013Whitney U<\/jats:italic>\u2010test for group comparison. ROC analysis for diagnostic performance. Significance criteria: p<\/jats:italic>\u2009<\u20090.05.<\/jats:p><\/jats:sec>Results<\/jats:title>LN patients had significantly higher F<\/jats:italic>\nR<\/jats:sub> (12.3%\u2009\u00b1\u20095.6% vs. 7.6%\u2009\u00b1\u20092.3%), lower F<\/jats:italic>\nPD<\/jats:sub> (36.3%\u2009\u00b1\u20099.1% vs. 29.6%\u2009\u00b1\u200913.0%), lower F<\/jats:italic>\nL<\/jats:sub> (30.1%\u2009\u00b1\u200912.1% vs. 24.8%\u2009\u00b1\u20097.6%), and higher ADC (1.95\u2009\u00b1\u20090.19 vs. 1.78\u2009\u00b1\u20090.22\u2009\u03bcm2<\/jats:sup>\/ms) than healthy volunteers. Patients with impaired renal function had significantly higher F<\/jats:italic>\nR<\/jats:sub> (11.1%\u2009\u00b1\u20095.3% vs. 15.4%\u2009\u00b1\u20095.2%), higher F<\/jats:italic>\nL<\/jats:sub> (27.8%\u2009\u00b1\u200910.8% vs. 36.0%\u2009\u00b1\u200913.5%), lower F<\/jats:italic>\nPD<\/jats:sub> (32.3%\u2009\u00b1\u200912.3% vs. 23.3%\u2009\u00b1\u200912.7%), and lower ADC (1.82\u2009\u00b1\u20090.19 vs. 1.69\u2009\u00b1\u20090.23\u2009\u03bcm2<\/jats:sup>\/ms). Proliferative LN patients had significantly increased FL<\/jats:sub> (31.8%\u2009\u00b1\u200912.1% vs. 24.8%\u2009\u00b1\u200911.2%) than non\u2010proliferative ones. For identifying patients with impaired function, F<\/jats:italic>\nR<\/jats:sub> showed numerically highest AUC (0.736), sensitivity (0.842), and balanced accuracy (0.730) at optimal point for Youden index. For identifying proliferative patients, F<\/jats:italic>\nL<\/jats:sub> showed numerically highest AUC (0.679), sensitivity (0.800), and negative predictive value (0.474) among single univariate models.<\/jats:p><\/jats:sec>Data Conclusion<\/jats:title>The compartment fractions can identify proliferative LN and impaired function, highlighting the potential of a histology\u2010driven compartment identification strategy.<\/jats:p><\/jats:sec>Evidence Level<\/jats:title>2.<\/jats:p><\/jats:sec>Technical Efficacy<\/jats:title>Stage 2.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.70022","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T01:26:30Z","timestamp":1751246790000},"page":"1437-1449","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Identification of Diffusion\u2010Relaxation Compartments Based on Correlation to Renal Pathological Scores: An Explorative Study on Lupus 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