Chronic lithium nephropathy: MR imaging for diagnosis.
OBJECTIVE
To evaluate the appearance of lithium nephropathy at magnetic resonance (MR) imaging.


METHODS
Sixteen patients with renal insufficiency and clinical and laboratory evidence of nephropathy secondary to therapy with lithium salts were examined with a 1.5-T MR imaging unit with T1-weighted, T2-weighted fast imaging with steady-state precession (true FISP), rapid acquisition with relaxation enhancement, half-Fourier turbo spin-echo, and gadolinium-enhanced (FISP three-dimensional MR angiographic) sequences. Renal size and the presence, number, location and size of parenchymal cysts were analyzed. The cysts in each kidney were defined as rare (fewer than 10 cysts), sparse (between 10 and 30 cysts), abundant (30-60 cysts), or very abundant (more than 60 cysts).


RESULTS
The mean length of both kidneys was 104 mm +/- 9 in seven cases, and one or both kidneys were less than 90 mm in length in nine cases. Renal microcysts measuring from 1 to 2 mm were detected in all patients. They were either very abundant (n = 12), abundant (n = 2), or sparse (n = 2). The cysts were located with equal abundance in both the cortex and the medulla in 11 cases and were predominantly located in the renal cortex in five cases. No renal artery stenosis was present.


CONCLUSIONS
Microcysts secondary to long-term lithium therapy can be detected with MR imaging.
Department of Radiology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine, 75020 Paris, France. bedouet.p@wanadoo.fr
Maria Teresa
MT
Farres
Pierre
P
Ronco
David
D
Saadoun
Philippe
P
Remy
François
F
Vincent
Antoine
A
Khalil
Alain Ferdinand
AF
Le Blanche
D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000139:chemically induced* / Q000175:diagnosis*; D052177:Kidney Diseases, Cystic / Q000139:chemically induced / Q000175:diagnosis; D007676:Kidney Failure, Chronic / Q000139:chemically induced / Q000175:diagnosis; D018020:Lithium Compounds / Q000009:adverse effects*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000473:pathology; D012189:Retrospective Studies
D018020:Lithium Compounds