title: Diffusion-weighted MRI of exercise-induced acute renal failure (ALPE).
abstract: Acute renal failure with severe loin pain induced by anaerobic exercise (ALPE) is a rare condition that is accompanied by wedge-shaped contrast enhancement on computed tomography (CT) without evidence of rhabdomyolysis. In two pediatric cases with ALPE, we tried to determine the relationship between findings from CT and magnetic resonance imaging (MRI). Case 1 involved a 13-year-old Japanese girl with a diagnosis of ALPE with normo-uricemia. Contrast-enhanced CT after 24 and 48 h showed a wedge-shaped excretion delay for the contrast media. A clear wedge-shaped signal hyperintensity matching the CT images was obtained by diffusion-weighted MRI. Case 2 involved a 16-year-old boy who presented with a second attack of ALPE after diagnosis of ALPE with hypouricemia 1 year earlier. Only diffusion-weighted imaging was performed. Clear wedge-shaped signal hyperintensity was apparent, similar to Case 1. MRI is safer than contrast-enhanced CT for patients with ALPE. Diffusion-weighted MRI is a very useful examination for diagnosing ALPE, providing noninvasive detection of lesions peculiar to ALPE.
authors: Department of Pediatrics, Kanazawa Medical Center, National Hospital Organization, 1-1 Shimo-Ishibiki, Kanazawa, Ishikawa 920-8650, Japan. kohta@kinbyou.hosp.go.jp
authors: Kazuhide
authors: K
authors: Ohta
authors: Tadafumi
authors: T
authors: Yokoyama
authors: Masaki
authors: M
authors: Shimizu
authors: Kazunori
authors: K
authors: Mizuno
authors: Shinobu
authors: S
authors: Sakazume
authors: Takuma
authors: T
authors: Fujiki
authors: Yutaka
authors: Y
authors: Saikawa
authors: Akihiro
authors: A
authors: Yachie
references: Nephron. 2002 Aug;91(4):559-70
references: 12138255
references: Nephron. 1991;59(2):254-60
references: 1835520
references: J Am Soc Nephrol. 2010 Jan;21(1):64-72
references: 19926891
references: Nephron. 1996;73(4):679-81
references: 8856269
references: J Am Soc Nephrol. 2004 Jan;15(1):164-73
references: 14694169
references: Pediatr Nephrol. 2009 May;24(5):999-1003
references: 19189137
references: Brain Dev. 2011 Mar;33(3):235-42
references: 20880644
references: Nephron. 1997;76(2):215-7
references: 9200414
references: Nephron. 1989;51(1):99-102
references: 2644569
references: Radiology. 2005 Jun;235(3):911-7
references: 15845792
references: Clin Nephrol. 2010 Feb;73(2):170-1
references: 20129027
references: Nephron. 1987;47(1):29-31
references: 3627334
references: J Comput Assist Tomogr. 1991 Nov-Dec;15(6):985-8
references: 1939778
references: Nephron. 1981;27(1):31-4
references: 7219634