title: Renal corticomedullary differentiation: observation in patients with differing serum creatinine levels.
abstract: OBJECTIVE
  To evaluate renal corticomedullary differentiation (CMD) in patients with differing serum creatinine (sCr) levels.
  
  
  METHODS
  Ten patients with normal sCr levels (0.9-1.3 mg/dL [80-115 mumol/L]), 14 with mildly elevated levels (1.5-2.9 mg/dL [133-256 mumol/L]), and 15 with elevated levels (> 3.0 mg/dL [265 mumol/L]) were examined with unenhanced T1-weighted fat-suppressed spin-echo (T1FS) and immediate gadolinium-enhanced gradient-echo (Gd-GRE) imaging.
  
  
  RESULTS
  Patients with normal sCr levels had CMD on T1FS and Gd-GRE images. Among patients with mildly elevated levels, seven did and seven did not have CMD on T1FS images; all had CMD on Gd-GRE images. Patients with elevated levels had no CMD on T1FS images; 13 had CMD on Gd-GRE images. Two patients with levels above 10.0 mg/dL (884 mumol/L) had no CMD on Gd-GRE images.
  
  
  CONCLUSIONS
  Independent of the cause of elevated sCr level, levels above 3.0 mg/dL result in loss of CMD on T1FS images, while levels above 10.0 mg/dL result in loss of CMD on Gd-GRE images.
authors.affiliation: Department of Radiology, University of North Carolina at Chapel Hill 27599.
authors.forename: R C
authors.initials: RC
authors.lastname: Semelka
authors.forename: K
authors.initials: K
authors.lastname: Corrigan
authors.forename: S M
authors.initials: SM
authors.lastname: Ascher
authors.forename: J J
authors.initials: JJ
authors.lastname: Brown
authors.forename: R E
authors.initials: RE
authors.lastname: Colindres
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003404:Creatinine / Q000097:blood*; D004338:Drug Combinations; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007672:Kidney Cortex / Q000473:pathology*; D007674:Kidney Diseases / Q000175:diagnosis / Q000473:pathology; D007679:Kidney Medulla / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives
chemical_list: D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D003404:Creatinine; D019786:Gadolinium DTPA