Renal-related perinephric fluid collections: MRI findings

We retrospectively reviewed MR studies on 10 patients with renal-related perinephric fluid collections who underwent MRI in three institutions between January 2001 and August 2004. All patients underwent MRI of the abdomen and T1-weighted, T2-weighted and serial contrast-enhanced images, including delayed-phase contrast-enhanced images 10-12 min after contrast injection, were obtained. Perinephric fluid collections in 5 patients revealed MRI findings of simple fluid content (i.e., hypointense on T1-weighted images and hyperintense on T2-weighted images). In another 5 patients, a complex perinephric fluid content (i.e., mixed hyper/hypointense on T1-weighted images and mixed hypo/hyperintense on T2-weighted images compatible with blood breakdown products and pus) was observed. In 5 patients, contrast extravasation on late-phase images that was compatible with urine leak was demonstrated. Our results suggest that MRI may determine the content of perinephric fluid collections on noncontrast T1-weighted and T2-weighted images and that contrast extravasation on late-phase images is associated with urine extravasation from renal collecting systems.