Renal corticomedullary differentiation: observation in patients with differing serum creatinine levels.
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.
Semelka
R C
RC
Department of Radiology, University of North Carolina at Chapel Hill 27599.
Corrigan
K
K
Ascher
S M
SM
Brown
J J
JJ
Colindres
R E
RE
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
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D003404:Creatinine; D019786:Gadolinium DTPA