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Author Spotlight: Developing a Bedside Protocol for Kidney and Genitourinary Ultrasonography
Published on: June 21, 2024
The striated MR nephrogram, not a reflection of pathology
Andrew T Trout1, Bin Zhang2, Marguerite M Care3
1Department of Radiology - MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA. andrew.trout@cchmc.org.
Background:
We have intermittently observed low signal striations in the kidneys on delayed post-contrast MR exams of the spine. While we suspected these striations were due to concentrated gadolinium, the clinical importance of this finding was uncertain.
Objective:
To describe the striated MR nephrogram (low signal striations in the kidney) and assess its clinical relevance.
Materials And Methods:
Retrospective review of delayed post-contrast MRIs of the spine (mean: 45 min after contrast administration). The presence of the striated MR nephrogram was correlated with imaging parameters (field strength, time since contrast), and findings (gadolinium in the bladder, inferior vena cava and aorta diameters) and with clinical factors (history of renal disease, laboratory values).
Results:
Seven hundred seventy-three exams performed on 229 patients, 8.3 ± 5.3 years of age, were reviewed. The striated MR nephrogram was observed in 102/773 examinations (13.2%) and was present on at least one study in 54/229 patients (23.6%). The presence of striations was associated with the specific magnet on which the exam was performed (P < 0.01) but not with magnet field strength. Serum creatinine was minimally lower in patients with striations (0.43 ± 0.12 vs. 0.49 ± 0.18 mg/dL, P = 0.002), but no other clinical or historical data, including time from contrast administration (P = 0.54), fluid status (P = 0.17) and clinical history of renal disease (P = 0.14), were predictive of the presence of striations.
Conclusion:
The striated MR nephrogram was observed in 13% of delayed post-contrast MR exams of the spine. Precipitating factors are unclear, but the striated nephrogram does not appear to be a marker of clinically apparent renal dysfunction.
Insights
Low signal striations in the kidney, termed striated MR nephrogram, were observed in 13% of spine MRIs. This finding is not associated with kidney dysfunction, suggesting it is not a marker of renal disease.
Area of Science:
- Radiology
- Nephrology
- Medical Imaging
Background:
- Delayed post-contrast Magnetic Resonance (MR) examinations of the spine can reveal low signal striations in the kidneys.
- The clinical significance of these striated MR nephrograms was previously uncertain.
Purpose of the Study:
- To characterize the striated MR nephrogram.
- To evaluate the clinical relevance of this imaging finding.
Main Methods:
- Retrospective analysis of 773 delayed post-contrast MRIs of the spine from 229 patients.
- Correlation of striated MR nephrogram presence with imaging parameters and clinical factors, including renal function tests.
Main Results:
- The striated MR nephrogram was identified in 13.2% of examinations (23.6% of patients).
- Presence was associated with the specific MR magnet used (P < 0.01) but not field strength or time since contrast administration.
- Serum creatinine was minimally lower in patients with striations, but no other clinical data predicted their presence.
Conclusions:
- The striated MR nephrogram is an occasional finding in delayed post-contrast spine MRIs.
- The underlying causes remain unclear.
- This finding does not appear to indicate clinically significant renal dysfunction.
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