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Related Experiment Videos

Renal transplant dysfunction: MR evaluation.

M Z Winsett1, E G Amparo, H D Fawcett

  • 1Department of Radiology, University of Texas Medical Branch, Galveston 77550.

AJR. American Journal of Roentgenology
|February 1, 1988
PubMed
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Magnetic resonance (MR) imaging shows limited accuracy in diagnosing renal transplant dysfunction. MR cannot replace biopsy for evaluating allograft rejection or other complications.

Area of Science:

  • Nephrology
  • Radiology
  • Transplant Surgery

Background:

  • Renal transplant dysfunction requires accurate diagnosis for timely intervention.
  • Magnetic resonance (MR) imaging is a non-invasive modality with potential for evaluating allograft health.

Purpose of the Study:

  • To determine the diagnostic role of MR imaging in evaluating renal allograft dysfunction.
  • To compare MR findings with clinical course and biopsy results in transplant recipients.

Main Methods:

  • Prospective comparison of 45 MR examinations with clinical outcomes and biopsy results in 38 renal transplant patients.
  • Assessment of corticomedullary differentiation, sinus fat, size, and shape for diagnosing rejection, acute tubular necrosis, drug toxicity, and pyelonephritis.

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Main Results:

  • Corticomedullary differentiation alone had low sensitivity (60%) and specificity (60%) for differentiating rejection from other causes of dysfunction.
  • Serial changes in corticomedullary differentiation were inconsistent for diagnosing rejection.
  • Combined MR abnormalities (sinus fat, size, shape, corticomedullary differentiation) improved sensitivity for rejection to 80% but decreased specificity to 48%.

Conclusions:

  • MR imaging is not accurate enough to replace renal transplant biopsy for diagnosing allograft dysfunction.
  • The current role of MR imaging in evaluating transplant dysfunction is limited.