Autosomal dominant polycystic kidney disease: MR imaging evaluation using current techniques

Abstract

Purpose: To determine the MR imaging findings of autosomal dominant polycystic kidney disease using current imaging techniques. Materials and Methods:We reviewed our five-year experience with MR imaging of autosomal dominant polycystic kidney disease (ADPKD) to determine the spectrum of appearance of kidney disease, the occurrence of cysts in other abdominal organs, the size and number of cysts in the kidneys and other organs, and the association with other benign or malignant disease. Thirty patients (17 men and 13 women, age range 30 to 88 years old) with ADPKD were included in this study. All patients were examined by MR imaging including T2-weighted single-shot echo-train spinecho and pre-and post-gadolinium chelate spoiled gradient-echo imaging.Results: All kidneys were involved with multiple, varying sized cysts scattered throughout the parenchyma. Giant renal cysts (Ͼ8 cm) were associated with pain in the only two patients who possessed them. Hemorrhage in renal cysts was observed in all kidneys with a heterogeneous pattern of involvement on non-contrast T1-and T2-weighted images, reflecting hemorrhage of varying age. The mean kidney size for the right kidney was 17.4 cm in length, 10.3 cm in transverse, and 9.4 cm in antero-posterior diameter (AP); and for the left kidney, 15.9 cm in the length, 9.3 cm in the transverse, and 9.3 cm in AP diameter. Other organs involved included the liver (22 patients), the pancreas (three patients), with two of the above-mentioned patients having both liver and pancreas cysts, and the spleen (one patient) who had both liver and splenic cysts. Massive liver involvement with large cysts was associated with abdominal pain. Malignant disease was present in five patients, including two patients with renal cell carcinoma, one with bladder cancer, one with lung cancer, and one patient with anal adenocarcinoma. Comparison of preand post-contrast T1-weighted images was essential to detect renal cancer. Conclusion:All kidneys in patients with ADPKD had extensive, varying-sized cysts and in all cases some cysts showed evidence of hemorrhage. The liver was the second most common organ to be involved with cystic disease, in 73% of patients. Large cysts in the kidneys and liver were associated with abdominal pain.

Monitoring kidney and renal cyst volumes applying MR approaches on a rapamycin treated mouse model of ADPKD

“…Since the clinical cyst measurements with the described technique are well characterized we did not perform histological correlation of the MR measurements at each time point, since we would have lost too many animals for the longitudinal in vivo measurements. In contrast to other studies [17], we were also able to establish a method to determine the CV without using contrast agents. This is favorable clinically [14], mainly due to the recent findings linking the administration of gadoliniumcontaining contrast agents to nephrogenic systemic fibrosis (NSF) [20,21], which limits the use of contrast agents in ADPKD-patients.…”

“…MRI has already proven to be a reliable method to measure renal volumetric indices in preclinical [4,12,13] and clinical studies [14][15][16][17]. Therefore, MRI-based volume measurements can be used as a reliable medium to detect the progression of the disease.…”

Carcinoma urotelial renal en una paciente con enfermedad renal poliquística autosómico dominante: Presentación de un caso y revisión de la literatura

“…Cuando se estudian por RM los quistes hemorrágicos presentarán una intensidad de señal variable en las distintas secuencias, dependiendo de la cronología del sangrado 3 .…”

Reliability of Magnetic Resonance Imaging for Measuring the Volumetric Indices in Autosomal-Dominant Polycystic Kidney Disease: Correlation with Hypertension and Renal Function

“…MRI has recently received a good deal of attention for evaluating the patients with ADPKD because MRI avoids the radiation exposure and the administration of iodinated contrast media that is associated with CT scanning [22]. T 2 -weighted images provide excellent contrast between the kidney parenchyma and the cysts without the administration of intravenous contrast because of their different water content [23].…”