Acute Tubular Necrosis

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Abstract
Sequential fast magnetic resonance (MR) images (repetition time 33 ms, echo time = 7 ms, α = 22°, one image every 12 s) were acquired using gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) (10 or 100 μmol/kg) to study perfusion and concentrating ability in normal rabbit kidneys and in kidneys with HgCl2-induced acute tubular necrosis (ATN). In normal rabbits receiving 100 μmol Gd-DTPA/kg a concentric region of decreased MR signal was observed. In sequential images the dark ring pattern migrated centripe-tally through the kidney moving from the corticomedullary junction to the inner medulla. The decrease in MR signal intensity occurred as a consequence of T2* relaxation (magnetic susceptibility) due to high concentration of Gd-DTPA within the tubules. This suggests that the dark ring pattern may serve as a qualitative feature indicative of the ability of the kidneys to concentrate. With the onset of HgCl2-induced ATN the pattern of enhancement due to Gd-DTPA administration changed markedly. Although the kidneys with ATN did continue to be perfused, the concentric dark ring pattern seen in normal kidneys receiving 100 μmol Gd-DTPA/kg was not observed. These results suggest that Gd-DTPA and fast imaging MR may provide a method of assessing perfusion and concentrating ability within the healthy or diseased kidney.