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Curvilinear areas in the perinephric fat seen on MR images
S Monzawa1, M D Schnall, R C Lee
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Aim:
On magnetic resonance (MR) images, strands correspond to curvilinear areas running in the perinephric fat, and haloes to those lying on the renal surface. Our aim was to examine the diagnostic significance and histopathological basis of these areas.
Patients And Methods:
MR images obtained in 46 patients without renal disease and 96 patients with renal disease were assessed for the signal intensity and extent of strands and haloes, and their degree of right-left asymmetry.
Results:
Strands usually revealed low signal intensity on T1-weighted MR images and high signal intensity on fat-suppressed T2-weighted images and contrast-enhanced fat-suppressed T1-weighted images. Haloes revealed high signal intensity on fat-suppressed T2-weighted images, but most of haloes were not clearly depicted on T1-weighted images or contrast-enhanced fat-suppressed T1-weighted images. Strands and haloes were common and usually symmetrical or only mildly asymmetrical in both patient groups. However, in 11 of the 96 patients with renal disease, prominent strands and/or haloes appeared with remarkable asymmetry and likely represented definite changes in the perinephric fat. At histopathology, vascular loose fibrous tissue was found at the sites of strands and haloes.
Conclusion:
Strands and haloes usually represent normal anatomical variations. However, the presence of prominent strands or haloes with remarkable right-left asymmetry implies abnormality and may provide additional information in the evaluation of renal disease.
Insights
Perinephric fat strands and haloes on MRI are usually normal variations. However, prominent, asymmetrical findings may indicate renal disease, warranting further investigation.
Area of Science:
- Radiology
- Renal Imaging
- Histopathology
Background:
- Magnetic resonance (MR) imaging reveals perinephric fat structures: strands and haloes.
- Understanding their diagnostic significance and histopathological basis is crucial.
Purpose of the Study:
- To investigate the diagnostic significance of perinephric fat strands and haloes.
- To determine the histopathological basis of these MR imaging findings.
Main Methods:
- MR images of 46 healthy individuals and 96 patients with renal disease were analyzed.
- Signal intensity, extent, and asymmetry of strands and haloes were assessed.
Main Results:
- Strands and haloes typically show specific signal intensities on various MR sequences.
- These findings were common and usually symmetrical in both groups.
- Remarkable asymmetry in prominent strands/haloes was observed in 11 patients with renal disease, suggesting perinephric fat changes.
Conclusions:
- Perinephric fat strands and haloes are generally normal anatomical variations.
- Prominent strands or haloes with significant right-left asymmetry may indicate underlying renal disease.