PENAL CORTICOMEDULLARY DIFFERENTIATION - OBSERVATION IN PATIENTS WITHDIFFERING SERUM CREATININE LEVELS

PURPOSE: To evaluate renal corticomedullary differentiation (CMD) in p atients with differing serum creatinine (sCr) levels. MATERIALS AND ME THODS: Ten patients with normal sCr levels (0.9-1.3 mg/dL [80-115 mu m ol/L]), 14 with mildly elevated levels (1.5-2.9 mg/dL [133-256 mu mol/ L]), and 15 with elevated levels (>3.0 mg/dL [265 mu mol/ L]) were exa mined 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. Am ong 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 e levated levels had no CMD on T1FS images; 13 had CMD on Gd-GRE images. Two patients with levels above 10.0 mg/dL (884 mu mol/L) had no CMD o n Gd-GRE images. CONCLUSION: Independent of the cause of elevated sCr level, levels above 3.0 mg/dL result in loss of CMD on T1FS images, wh ile levels above 10.0 mg/dL result in loss of CMD on Gd-GRE images.