Comparison of magnetic resonance imaging and radionuclide imaging in the evaluation of renal transplant failure.
Magnetic resonance imaging (MRI) was compared with radionuclide scintigraphy (RNS) in 16 patients with renal transplants undergoing renal failure to determine which modality could best discriminate between rejection, acute tubular necrosis (ATN), and cyclosporin nephrotoxicity (CN). Although all rejecting transplants had reduced corticomedullary differentiation (CMD) on T1-weighted MR images, four of five cases of ATN had appearances that could not be distinguished from rejection. A normal CMD suggests nonrejection, but diminished CMD is nonspecific. Tc-99m DTPA/I-131 hippuran RNS was superior to MRI in differentiating rejection from ATN. Although ATN and CN have similar RNS patterns, this distinction can usually be made based on the clinical time course. Other potential uses of MRI in the evaluation of the renal transplants are discussed.
Goldsmith
M S
MS
Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, California 90048.
Tanasescu
D E
DE
Waxman
A D
AD
Crues
J V
JV
D058186:Acute Kidney Injury / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D003524:Cyclosporins / Q000009:adverse effects*; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007465:Iodohippuric Acid; D007668:Kidney / Q000187:drug effects; D016030:Kidney Transplantation; D007683:Kidney Tubular Necrosis, Acute / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid; D011877:Radionuclide Imaging; D016284:Technetium Tc 99m Pentetate
D003524:Cyclosporins; D009942:Organometallic Compounds; D007465:Iodohippuric Acid; D004369:Pentetic Acid; D016284:Technetium Tc 99m Pentetate