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Effects of lithotripsy on rat kidney: evaluation with MR imaging, histology, and electron microscopy
J Neuerburg1, H J Daus, F Recker
1Department of Diagnostic Radiology, University of Aachen, Medical Faculty F.R.G.
Abstract:
Magnetic resonance (MR) imaging at 1.5 T was used to evaluate the effects of extracorporeal shock wave lithotripsy (ESWL) in 30 rats and the findings on T1- and T2-weighted (spin echo 600/22, 1,600-2,000/90) images were compared with histology and scanning microscopy. The observed pathologic changes increased in severity with the number of shock waves given (500-5,000 15 kV). Post-ESWL MR findings in 54 kidneys included perirenal and subcapsular fluid (n = 30), diffuse loss of corticomedullary junction definition (n = 28), intrarenal foci of increased (n = 7) or decreased (n = 6) signal intensity, focal indentation of the renal contour (n = 5), and loss of distinction between the renal, splenic, or hepatic contour (n = 7). The subcapsular and intrarenal findings corresponded pathologically to areas of hemorrhage and hematoma formation--the contour changes to foci of renal scarring or perirenal adhesions. Electron microscopy demonstrated marked alterations of the renal tubules and vasculature. The study shows the feasibility of assessing the nature and chronology of renal damage post-ESWL in a rat model by MR.
Insights
Magnetic resonance imaging effectively detects kidney damage after extracorporeal shock wave lithotripsy (ESWL) in rats. Findings correlate with histology, showing MR can assess ESWL-induced renal injury.
Area of Science:
- Radiology
- Nephrology
- Pathology
Background:
- Extracorporeal shock wave lithotripsy (ESWL) is a common procedure for kidney stone removal.
- Understanding the potential renal damage caused by ESWL is crucial for patient safety.
- Non-invasive imaging techniques can aid in evaluating these effects.
Purpose of the Study:
- To evaluate the utility of Magnetic Resonance (MR) imaging in assessing renal damage following ESWL in a rat model.
- To correlate MR imaging findings with histological and scanning electron microscopy results.
- To establish the feasibility of MR imaging for characterizing the nature and timeline of post-ESWL renal injury.
Main Methods:
- MR imaging at 1.5 T was performed on 30 rats post-ESWL.
- T1- and T2-weighted images were analyzed and compared with histological findings.
- Scanning electron microscopy was used to examine renal tissue alterations.
Main Results:
- Pathologic changes severity correlated with the number of shock waves administered.
- Common MR findings included perirenal/subcapsular fluid, loss of corticomedullary definition, intrarenal signal intensity foci, and contour abnormalities.
- MR findings corresponded to hemorrhage, hematoma, renal scarring, and adhesions; electron microscopy revealed tubular and vascular damage.
Conclusions:
- MR imaging is a feasible method for evaluating the extent and type of renal damage after ESWL in a rat model.
- MR findings correlate well with established pathological changes.
- This study demonstrates the potential of MR imaging to assess the chronology of renal injury post-ESWL.