Correlation of quantitative dynamic magnetic resonance imaging findings with pathology results in renal transplants: a preliminary report

Abstract

ENAL transplantation is being used worldwide to spare chronic renal insufficiency patients from hemodialysis and to improve their quality of life. Medical and surgical complications have increased along with the number of transplantations performed. There are many causes of renal allograft dysfunction, the most significant being acute rejection, cyclosporine (CyA) toxicity, acute tubular necrosis, and chronic rejection. 1 It is particularly important to differentiate between acute rejection and CyA toxicity, because the dosage of immunosuppressive therapy should be increased in the former, but decreased in the latter condition. Biopsy remains the technique of choice for reaching a definitive diagnosis, but this procedure carries the risk of complications, such as major hemorrhage and infection that can occasionally result in graft loss. 2,3 Various noninvasive methods have been used to evaluate renal allograft dysfunction. The most common are serum creatinine levels, Doppler ultrasonography, and renal scintigraphy. However, none of these are specific enough to differentiate acute rejection from CyA toxicity. 4,5 The aim of this study was to assess dynamic magnetic resonance imaging (MRI) as a possible effective noninvasive technique to differentiate between rejection and CyA toxicity.