Renal handling of X-ray contrast media imaging and exploration with electron beam CT

Physiologic changes in renal hemodynamics and function reflect its role as a regulatory organ in maintaining homeostasis, whereas other alterations may mirror development of renal injury and often precede overt signs of morphologic changes. Furthermore, intrarenal alterations may be discreet and manifest only in the renal cortical, medullary, or papillary zones. The high spatial and temporal resolution of electron-beam computed tomography enables external detection and quantification of cortical, medullary, and papillary tissue density changes following an intravenous bolus injection of X-ray contrast media. These changes reflect flow of contrast media in these renal zones through the successive renal vascular, glomerular, and tubular compartments that can be individually plotted as time-density curves (TDC). Mathematical modeling then allows calculation of unique parameters of renal function from these TDC. This ability to quantify renal regional attributes may not only shed light on the physiologic mechanisms that the kidney controls, but also assist in detecting subtle impairment in its function.