Corticomedullary differentiation of the kidney: evaluation with noncontrast-enhanced steady-state free precession (SSFP) MRI with time-spatial labeling inversion pulse (time-SLIP)

J Magn Reson Imaging. 2013 May;37(5):1178-81. doi: 10.1002/jmri.23909. Epub 2012 Nov 13.

Abstract

Purpose: To assess whether noncontrast-enhanced steady-state free precession (SSFP) magnetic resonance imaging (MRI) with time-spatial labeling inversion pulse (Time-SLIP) can improve the visibility of corticomedullary differentiation of the normal kidney.

Materials and methods: A series of noncontrast-enhanced SSFP MRI with Time-SLIP were performed in 20 patients by using various inversion times (TIs); 500-1800 msec in increments of 100 msec. In-phase (IP) and opposed-phase (OP) MR images were also obtained. The signal intensity (SI) of the renal cortex and medulla was measured to calculate corticomedullary contrast ratio (SI of cortex/medulla). Additionally, the visibility of corticomedullary differentiation was visually categorized using a four-point scale.

Results: In SSFP with Time-SLIP, corticomedullary contrast ratio was highest with TI of 1200 msec in eight subjects (40%), followed by 1100 msec in seven (35%) and 1000 msec in three (15%). The corticomedullary contrast ratio in SSFP with optimal Time-SLIP (4.93 ± 1.25) was significantly higher (P < 0.001) than those of IP (1.46 ± 0.12) and OP (1.43 ± 0.14). The visibility of corticomedullary differentiation was significantly better (P < 0.001) in SSFP images with Time-SLIP (averaged grade = 4.0) than in IP images (averaged grade = 2.63) and OP images (averaged grade = 2.05).

Conclusion: SSFP MRI with Time-SLIP can improve the visibility of renal corticomedullary differentiation without using contrast agents.

MeSH terms

  • Adult
  • Algorithms*
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Humans
  • Image Enhancement / methods*
  • Image Interpretation, Computer-Assisted / methods*
  • Kidney Cortex / anatomy & histology*
  • Kidney Medulla / anatomy & histology*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Observer Variation
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Spin Labels
  • Young Adult

Substances

  • Contrast Media
  • Spin Labels