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Related Experiment Videos

Obstructive nephropathy: evaluation with dynamic Gd-DTPA-enhanced MR imaging.

R C Semelka1, H Hricak, E Tomei

  • 1Department of Radiology, University of California, San Francisco 94143.

Radiology
|June 1, 1990
PubMed
Summary

Dynamic contrast-enhanced MRI using gadolinium diethylenetriaminepentaacetic acid (DTPA) effectively differentiates kidney obstruction. Acute obstruction prolongs the early tubular phase, while chronic obstruction reduces cortical enhancement.

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Area of Science:

  • Nephrology
  • Radiology
  • Medical Imaging

Background:

  • Obstructive nephropathy poses a significant diagnostic challenge.
  • Dynamic contrast-enhanced magnetic resonance (MR) imaging offers potential for evaluating renal function and obstruction.

Purpose of the Study:

  • To assess the utility of dynamic gadolinium diethylenetriaminepentaacetic acid (DTPA)-enhanced MR imaging in characterizing obstructive nephropathy.
  • To differentiate between normal, dilated nonobstructed, acutely obstructed, and chronically obstructed kidneys.

Main Methods:

  • Utilized a 1.5-T magnet for dynamic contrast-enhanced MR imaging in 27 subjects.
  • Analyzed morphologic findings and quantitative temporal changes in signal intensity post-DTPA injection.
  • Identified four distinct enhancement phases in normal kidneys: cortical, early tubular, ductal, and excretory.

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Main Results:

  • Normal and dilated nonobstructed kidneys showed similar enhancement patterns.
  • Acutely obstructed kidneys exhibited normal cortical enhancement but increased medullary enhancement, impairing corticomedullary differentiation.
  • Acutely obstructed kidneys displayed a prolonged early tubular phase (until 2.5 minutes) with delayed ductal and excretory phases.
  • Chronically obstructed kidneys demonstrated reduced cortical enhancement (13% increase) and a prolonged early tubular phase, with diminished or absent ductal phases.

Conclusions:

  • Dynamic DTPA-enhanced MR imaging is valuable for diagnosing and characterizing obstructive nephropathy.
  • Distinct enhancement patterns observed in acute and chronic obstruction aid in differentiation.
  • This technique provides quantitative insights into renal hemodynamic and excretory function in obstruction.