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Detection of renal ischemic lesions using Gd-DTPA enhanced turbo FLASH MRI: experimental and clinical results
R Vosshenrich1, M Kallerhoff, H J Gröne
1Department of Radiology, University of Göttingen, Germany.
Purpose:
Our goal was to investigate the role of Gd-DTPA-enhanced dynamic MRI in the evaluation of renal ischemic lesions.
Method:
With a turbo FLASH sequence before and after injection of Gd-DTPA, nine foxhound dogs after 60-120 min of renal ischemia underwent MR examination. In addition, five patients with a tumor in a solitary kidney were examined before and after nephron-sparing renal surgery to evaluate renal perfusion and function. The experimental and clinical findings were correlated with conventional measurements of kidney function and with histological findings.
Results:
Complete renal ischemia leads to a poor corticomedullary differentiation in Gd-DTPA-enhanced turbo FLASH MRI. The signal-intensity-versus-time plots of kidneys with significant postischemic changes show a less steep increase of signal intensity in the cortex and a steeper increase of signal intensity in the medulla than those of normal kidneys.
Conclusion:
Dynamic MRI demonstrate renal morphology and reflect the functional status of renal vasculature.
Insights
Dynamic MRI with Gd-DTPA effectively evaluates renal ischemic lesions by showing poor corticomedullary differentiation. This technique reflects the functional status of renal vasculature in ischemic kidneys.
Area of Science:
- Radiology
- Nephrology
- Medical Imaging
Background:
- Renal ischemic lesions can impair kidney function.
- Accurate evaluation of renal perfusion and function is crucial for patient outcomes.
- Magnetic Resonance Imaging (MRI) offers advanced visualization capabilities.
Purpose of the Study:
- To investigate the utility of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA)-enhanced dynamic MRI in assessing renal ischemic lesions.
- To correlate MRI findings with conventional kidney function tests and histology.
Main Methods:
- Utilized a turbo FLASH sequence with Gd-DTPA contrast agent.
- Examined nine foxhound dogs with induced renal ischemia (60-120 min).
- Evaluated five patients with solitary kidney tumors before and after nephron-sparing surgery.
Main Results:
- Complete renal ischemia resulted in poor corticomedullary differentiation on Gd-DTPA-enhanced MRI.
- Signal-intensity-versus-time plots showed altered cortical and medullary enhancement patterns in ischemic kidneys compared to normal kidneys.
Conclusions:
- Dynamic MRI effectively demonstrates renal morphology.
- Gd-DTPA-enhanced MRI reflects the functional status of renal vasculature in ischemic conditions.