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[Magnetic resonance tomography without and with gadolinium-DTPA for evaluating kidney transplants]
T Vestring1, K H Dietl, S Heidenreich
1Institut für Klinische Radiologie, Westfälische Wilhelms-Universität Münster.
Purpose:
To determine the value of MR imaging in differentiating the various causes of human renal allograft dysfunction.
Methods:
A total of 123 human renal allografts (normal n = 20, acute rejection n = 57, acute tubular necrosis n = 14, interstitial fibrosis n = 11, chromic allograft glomerulopathy n = 11, cyclosporine nephrotoxicity n = 3, cortical necrosis n = 7) were investigated by means of MR imaging. Axial T1-weighted spin-echo images and coronal T1-weighted gradient-echo images were obtained before and after Gd-DTPA injection. Diagnostic parameters included corticomedullary contrast and allograft size and shape on the pre-contrast sequences.
Results:
None of the diagnostic parameters used could differentiate among the various diagnostic groups. Diagnostic of cortical necrosis could be made only on post-contrast scans. Contrast-enhanced scans were superior to pre-contrast images in detection of focal allograft lesions. Otherwise, contrast-enhanced scans did not provide any more information than pre-contrast studies. Spin-echo and gradient-echo sequences displayed the same diagnostic value.
Conclusions:
MR imaging has a limited value in differentiating the various causes of renal allograft dysfunction.