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Five cardiac arrest rats died during the procedure, resulting in 10 cardiac arrest and 9 sham rats for analysis. IVIM-MRI and renal parameters were assessed 24\u2009h after cardiac arrest and cardiopulmonary resuscitation. Diffusion-related parameters, including apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), and exponential ADC (eADC), were obtained. The primary imaging endpoint was defined as D. Following completion of MRI, renal function, histopathology, and expression of apoptosis markers (Bcl-2, Caspase-3), water channel protein aquaporin-3, and tight junction proteins (zonula occludens-1, occludin) were subsequently evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Despite preserved conventional renal function, IVIM MRI detected early renal alterations 24\u2009h after cardiac arrest. Compared with the sham group, eADC, D, ADC, D*, and f values were all significantly reduced. Histopathological analysis revealed pronounced tubular epithelial injury, increased apoptosis (Bcl-2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; Caspase-3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), and reduced expression of aquaporin-3 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039), zonula occludens-1 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and occludin (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IVIM MRI enables early, noninvasive detection of renal injury 24\u2009h after cardiac arrest and CPR, reflecting tubular injury, tight junction disruption, and perfusion deficits, potentially facilitating timely intervention and improving prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance statement<\/jats:title>\n                    <jats:p>This approach may facilitate individualized therapy and improve post-cardiac arrest syndrome outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>The long-term outcomes of cardiac arrest remain poor due to post-cardiac arrest syndrome.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>IVIM MRI enables early, noninvasive detection of renal injury after cardiac arrest and cardiopulmonary resuscitation.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>This approach may facilitate individualized therapy and improve post-cardiac arrest syndrome.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s41747-026-00729-8","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T09:33:18Z","timestamp":1778664798000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intravoxel incoherent motion MRI for early detection and assessment of renal injury after cardiac arrest and resuscitation in a rat model"],"prefix":"10.1186","volume":"10","author":[{"given":"Jie","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoyi","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siqi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunke","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinzhao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teng","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhihua","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9793-6910","authenticated-orcid":false,"given":"Zhengfei","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhifeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"729_CR1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-2773-2","volume":"24","author":"S Yan","year":"2020","unstructured":"Yan S, Gan Y, Jiang N et al (2020) The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis. 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