Magnetic resonance imaging of the peritoneal cavity among peritoneal dialysis patients, using the dialysate as "contrast medium".
The objectives of this study were to evaluate whether adequate observation of abdominal pathologic features related to peritoneal dialysis (PD) was possible with magnetic resonance imaging (MRI) under routine conditions, i.e., against the background of the dialysate and without contrast medium. For 16 male and seven female patients (mean age, 51.8 +/- 15.0 yr; mean duration of PD, 324 +/- 542 d), 25 peritoneal MRI studies were performed with the intraperitoneal dialysate as usual. Indications were symptoms or combinations of symptoms, such as leakage or abdominal wall edema (n = 3), bloody dialysate (n = 4), suspected herniation (n = 1), suspected ultrafiltration failure (n = 2), and abdominal pain (n = 5), or routine assessment after initiation of PD (n = 12). The MRI protocol, which was performed with a 1.0-T scanner, consisted of breath-hold, coronal and transverse, T2-weighted, half-Fourier single-shot turbo spin-echo sequences, using a standard body-array coil. MRI studies were well tolerated and successfully completed for all except two patients. Results indicated a leak along the catheter (n = 1), a leak in an umbilical hernia (n = 1), suspected leakage (n = 1), hernias (n = 5, in three patients), intraperitoneal adhesions (n = 5, in four patients), a ruptured ovarian cyst (n = 1), and pleural effusions (n = 4). Pathologic findings unrelated to PD or located extra-abdominally were observed in 19 of the 25 studies. The catheter tip position was easily identified for all patients. In conclusion, this first report on peritoneal MRI using only dialysate as the "contrast medium" indicates that MRI permits detailed observation of all relevant, PD-related, abdominal pathologic features against the dialysate background, thus avoiding system contamination (and thus the risk of peritonitis).
Prischl
Friedrich C
FC
*Third Department of Medicine/Nephrology and Second Department of Radiology, Krankenhaus der Barmherzigen Schwestern vom Hl. Kreuz, Wels, Austria.
Muhr
Thomas
T
*Third Department of Medicine/Nephrology and Second Department of Radiology, Krankenhaus der Barmherzigen Schwestern vom Hl. Kreuz, Wels, Austria.
Seiringer
Eva M
EM
*Third Department of Medicine/Nephrology and Second Department of Radiology, Krankenhaus der Barmherzigen Schwestern vom Hl. Kreuz, Wels, Austria.
Funk
Siegfried
S
*Third Department of Medicine/Nephrology and Second Department of Radiology, Krankenhaus der Barmherzigen Schwestern vom Hl. Kreuz, Wels, Austria.
Kronabethleitner
Gert
G
*Third Department of Medicine/Nephrology and Second Department of Radiology, Krankenhaus der Barmherzigen Schwestern vom Hl. Kreuz, Wels, Austria.
Wallner
Manfred
M
*Third Department of Medicine/Nephrology and Second Department of Radiology, Krankenhaus der Barmherzigen Schwestern vom Hl. Kreuz, Wels, Austria.
Artmann
Wolfgang
W
*Third Department of Medicine/Nephrology and Second Department of Radiology, Krankenhaus der Barmherzigen Schwestern vom Hl. Kreuz, Wels, Austria.
Kramar
Reinhard
R
*Third Department of Medicine/Nephrology and Second Department of Radiology, Krankenhaus der Barmherzigen Schwestern vom Hl. Kreuz, Wels, Austria.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006547:Hernia / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010048:Ovarian Cysts / Q000175:diagnosis; D010529:Peritoneal Cavity / Q000473:pathology*; D010530:Peritoneal Dialysis; D010532:Peritoneal Diseases / Q000175:diagnosis*; D000267:Tissue Adhesions / Q000175:diagnosis
D003287:Contrast Media