Renal MRI findings and their clinical associations in nephropathia epidemica: analysis of quantitative findings
- 72 Downloads
Morphologic renal magnetic resonance imaging (MRI) findings in patients with nephropathia epidemica (NE) were evaluated, and these findings were correlated with the clinical course of NE. Renal MRI was performed in 20 hospitalized NE patients during the acute phase of their disease. A repeat MRI study was made 5–8 months later. Renal parenchymal volume, renal length and parenchymal thickness were decreased in all patients in the repeat study. Edema/fluid collections were found bilaterally in 16 patients in the primary MRI study. Greater change in parenchymal volume, renal length and parenchymal thickness between the primary and the repeat MRI study as well as the presence of edema/fluid collections in the primary study evinced mild association with clinical fluid volume overload, high blood pressure level, inflammation, thrombocytopenia and severe clinical renal insufficiency. Change in parenchymal volume was associated with a severe clinical course more markedly than the other MRI findings. Measurable renal MRI changes occurred in every NE patient. The severity of the findings in MRI evinced mild association with clinical fluid volume overload, high blood pressure level, inflammation, thrombocytopenia and severe clinical renal insufficiency. Based on this study and our previous ultrasound (US) findings, we prefer US as the primary examination mode in NE patients.
KeywordsAcute renal failure Hantavirus infection Nephropathia epidemica MRI Renal imaging
This study was supported financially by the Medical Research Fund of Tampere University Hospital, the Research Fund of Tampere University, the Radiological Society of Finland, the Research Fund of Tampere City, and the Finnish Kidney Foundation and European Commission Project “Diagnostics and control of rodent-borne viral zoonoses in Europe” (QLK2-CT-2002-01358).
- 2.Lee HW, Lee PW, Baek LJ, Chu YK (1990) Geographical distribution of hemorrhagic fever with renal syndrome and hantaviruses. Arch Virol [Suppl]1:5–18Google Scholar
- 3.Lähdevirta J (1971) Nephropathia epidemica in Finland: a clinical, histological and epidemiological study. Ann Clin Res 3 [Suppl 8]:11–151Google Scholar
- 6.Collan Y, Mihatsch MJ, Lähdevirta J, Jokinen EJ, Romppanen T, Jantunen E (1991) Nephropathia epidemica: mild variant of hemorrhagic fever with renal syndrome. Kidney Int 49 [Suppl 35]:62–71Google Scholar
- 10.Demas BE, Stafford SA, Hricak H (1988) Kidneys. In: Stark DD, Bradley WG (eds) Magnetic resonance imaging. Mosby, St Louis, p 1221Google Scholar
- 13.Heinonen T, Eskola H, Dastidar P, Malmivuo J (1997) Segmentation of the skull using T1 MR scans. J Comput Methods Programs Biomed 54:173–181Google Scholar
- 14.Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 8:307–310Google Scholar