Contrast-enhanced MR imaging of experimental acute tubular necrosis

Purpose: To demonstrate the involvement of the various renal structures in acute tubular necrosis (ATN). Material and Method's: In 15 rats, using a T1-/T2-weighted sequence, either gadodiamide alone, or gadodiamide in combination with sprodiamide (a susce ptibility agent) were used to enhance the various anatomical substrates of the kidney. The results were compared to those of pathological verification . Results: Experimentally induced ATN of the rat kidney causes profound chang es in the medulla, leaving the cortex largely intact. The difference betwee n the normal cortex and the partially necrotic outer medulla, on the one ha nd, and the papillary region, was significantly enhanced with the combinati on, whereas a larger region composed of the inner and outer medulla was enh anced after the gadolinium chelate alone. Conclusion: The results varied considerably between the two procedures; the double contrast demonstrated a clear difference between the inner and oute r medulla. and the gadolinium chelate alone demonstrated a clear difference between the medulla and the cortex. These results demonstrated a clear dif ference in the compartmentalization between the inner and outer medullary r egions, providing complementary information about the pathological conditio n of the kidney.