title: Renal lesion characterization with gadolinium-enhanced MR imaging: efficacy and safety in patients with renal insufficiency.
abstract: Five patients with renal insufficiency were studied with T1-weighted magnetic resonance (MR) imaging before and after intravenous administration of gadopentetate dimeglumine (0.1 mmol/kg) to characterize renal lesions that were detected with nonenhanced computed tomography (CT) and were considered indeterminate. Four patients demonstrated renal lesions that enhanced after gadolinium administration. A total of five lesions in these four patients were surgically resected and found to be renal cell carcinoma at pathologic examination. The fifth patient was spared surgery because a hyperattenuated lesion noted at nonenhanced CT did not enhance with intravenous gadolinium, indicating a benign cyst. Five incidentally occurring benign cysts removed at the time of nephrectomy in two of the patients did not demonstrate enhancement with gadolinium on MR images. Serial serum creatine levels were obtained before and after gadolinium administration in all patients; no changes were noted after gadolinium administration. Gadolinium-enhanced MR imaging is an effective method for characterizing renal lesions in patients with renal insufficiency. At the usual dosage, there appears to be no nephrotoxic reaction in these patients.
authors.affiliation: Department of Radiology, New York University School of Medicine, New York, University Medical Center, NY 10016.
authors.forename: N M
authors.initials: NM
authors.lastname: Rofsky
authors.forename: J C
authors.initials: JC
authors.lastname: Weinreb
authors.forename: M A
authors.initials: MA
authors.lastname: Bosniak
authors.forename: R B
authors.initials: RB
authors.lastname: Libes
authors.forename: B A
authors.initials: BA
authors.lastname: Birnbaum
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000175:diagnosis*; D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D007668:Kidney / Q000473:pathology; D052177:Kidney Diseases, Cystic / Q000150:complications / Q000175:diagnosis; D007676:Kidney Failure, Chronic / Q000150:complications*; D007680:Kidney Neoplasms / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D009942:Organometallic Compounds / Q000009:adverse effects; D004369:Pentetic Acid / Q000009:adverse effects
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA