Persistent CT nephrograms following cardiac catheterisation and intervention: initial observations

Abstract

ObjectivesTo describe persistent nephrographic patterns detected by unenhanced renal CT at 24 h after cardiac catheterisation and intervention.MethodsThis prospective study was Health Insurance Portability and Accountability Act-compliant and institutional review board approved. Twenty-nine patients (20 men, nine women; average age 63.27 and range 41–85 years) agreed to undergo unenhanced dual-energy computed tomography (CT) limited to their kidneys at 24 h after cardiac catheterisation. CT attenuation values (Hounsfield units) were made from the cortical and medullary regions and single kidney total parenchymal iodine values (milligrams) were measured. Spearman’s rank correlation coefficient and a two-sided Fisher’s exact test were used in the statistics.ResultsFocal nephrograms were observed in at least one kidney (range, one to five regions per kidney) in 10/29 (34%) of patients and bilateral global nephrograms in 13/29 (45%) of patients. Focal nephrograms correlated with cardiac catheterisation fluoroscopic time (r = 0.48; P = 0.0087). For global nephrograms, the total iodine content of right and left kidneys correlated with fluoroscopic time (r = 0.79 and 0.76; P < 0.0001, respectively) and the amount of contrast material (CM) used (r = 0.77 and r = 0.74; P < 0.0001, respectively).ConclusionPersistent focal and global nephrograms occur commonly as assessed by non-contrast CT at 24 h post cardiac catheterisation and our observations suggest they could be related to procedural factors.Electronic supplementary materialThe online version of this article (doi:10.1007/s13244-011-0131-2) contains supplementary material, which is available to authorized users.

Contrast Media: Are There Differences in Nephrotoxicity among Contrast Media?

“…They assumed that any increase in creatinine following contrast exposure was caused by the contrast (no adjudication for other causes of a rise in serum creatinine). Katzberg et al noted persistent global and focal nephrograms on CT performed 24 hours following administration of isosmolar contrast for coronary angiography [ 17 ]. Such findings might be explained by microemboli rather than contrast-induced nephrotoxicity.…”