Magnetic Resonance Imaging of Acute and Long-Term Alterations following Extracorporeal Shock Wave Lithotripsy in Rats

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Abstract
The kidneys of 30 rats were treated by extracorporeal shock wave lithotripsy (ESWL) with different doses of extracorporeal shock waves: 500, 1,000 and 2,000. The animals were sacrificed after 24 h, 7, 14 or 35 days. Magnetic resonance (MR) imaging at 1.5T was used to evaluate the effects of ESWL on T1- and T2-weighted (spin echo 600/22, 1,600–2,000/90) images compared to histology and macroscopy. The severity of pathologic changes correlated dose dependently with the number of shock waves given (500–2,000). The MR findings following ESWL in 50 kidneys included diffuse loss of the corticomedullary junction (n = 20), perirenal and subcapsular fluid (n = 23), intrarenal foci of increased (n = 16) or decreased (n = 8) signal intensity, and loss of distinction between renal, splenic or hepatic contours (n = 7), detected macroscopically as adhesions. Subcapsular and intrarenal findings corresponded to acute hematomas and organized fibrotic tissue morphologically. In long-term groups MR revealed fibrotic shrinkage of the renal convexity as indentation of the kidney surface (n = 12). MR imaging is a sensitive method for the detection of specific alterations following ESWL, especially intrarenal changes, which are important for possible long-term lesions after ESWL.

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