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Paroxysmal nocturnal hemoglobinuria: MR findings
1Department of Radiology, University of Tsukuba, Ibaraki, Japan.
Journal of Computer Assisted Tomography
|September 1, 1993
Summary
Gradient echo imaging, a type of MRI, effectively detects hemosiderin in paroxysmal nocturnal hemoglobinuria (PNH) patients. This method is superior to T2-weighted imaging for diagnosing PNH-related kidney complications.
Area of Science:
- Radiology
- Nephrology
- Hematology
Background:
- Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired hemolytic disorder.
- PNH is characterized by hemosiderin deposition in proximal renal tubules.
Purpose of the Study:
- To evaluate the utility of MRI, specifically gradient echo imaging, in detecting renal hemosiderin deposition in patients with PNH.
Main Methods:
- Six patients with PNH were examined using MRI.
- Gradient echo imaging (T2*-weighted) and T2-weighted imaging sequences were utilized.
Main Results:
- A characteristic hypointense pattern was observed in five out of six PNH patients on T2- and T2*-weighted imaging.
- The extent of the hypointense area correlated with the time since the last hemolytic attack.
Conclusions:
- T2*-weighted imaging (gradient echo imaging) is more sensitive than T2-weighted imaging for detecting renal cortical hemosiderin in PNH.
- Gradient echo imaging offers higher sensitivity to magnetic susceptibility effects and shorter examination times.
- Reversal of the normal cortical-to-medullary intensity ratio on T1-weighted imaging was not observed in this study.