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Nephrotoxic nephritis and obstructive nephropathy: evaluation with MR imaging enhanced with ultrasmall
O Hauger1, C Delalande, C Deminière
1Unité Mixte de Recherche 5639, Centre National de la Recherche Scientifique (CNRS), Magnetic Resonance of Biologic Systems, Université Victor Ségalen, Bordeaux, France.
Purpose:
To evaluate the role of magnetic resonance (MR) imaging enhanced with ultrasmall superparamagnetic iron oxide (USPIO) in the evaluation and differentiation of different types of nephropathies.
Materials And Methods:
Two experimental rat models of nephropathies were studied: a model of nephrotoxic nephritis induced by means of intravenous injection of sheep anti-rat glomerular basement membrane serum (n = 43) and a model of obstructive nephropathy (n = 6). Imaging sessions were performed with a spectrometer operating at 4.7 T with fast low-angle shot, or FLASH, sequences. Signal intensity was measured in each kidney compartment before and 24 hours after intravenous injection of USPIO (90 micromol of iron per kilogram of body weight). MR findings were compared with histologic data and urine protein levels.
Results:
In the nephrotoxic nephritis model 24 hours after injection of USPIO, a significant signal intensity decrease (P: <.05) was present only in the cortex where the glomerular lesions were located. In the obstructive nephropathy model, the signal intensity decrease (P: <.05) was located in all kidney compartments in response to diffuse interstitial lesions. The decrease in signal intensity was due to iron uptake by either macrophages or mesangial cells gaining endocytic activity and was correlated, in the nephrotoxic nephritis model, to the degree of proteinuria.
Conclusion:
Twenty-four-hour delayed USPIO-enhanced MR imaging may help identify and differentiate various types of nephropathies.