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DOI: 10.1148/radiol.2292020758
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(Radiology 2003;229:570-574.)
© RSNA, 2003

Genitourinary Imaging

Chronic Lithium Nephropathy: MR Imaging for Diagnosis1

Maria Teresa Farres, MD, Pierre Ronco, MD, PhD, David Saadoun, MD, Philippe Remy, MD, François Vincent, MD, Antoine Khalil, MD and Alain Ferdinand Le Blanche, MD, PhD

1 From the Departments of Radiology (M.T.F., A.K., A.F.L.B.) and Nephrology (D.S., F.V.), Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine, 75020 Paris, France; Department of Nephrology, Université Pierre et Marie Curie, Paris, France (P. Ronco); and Department of Nephrology, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, France (P. Remy). Received June 21, 2002; revision requested August 21; final revision received June 4, 2003; accepted June 9. Address correspondence to M.T.F. (e-mail: bedouet.p@wanadoo.fr).

PURPOSE: To evaluate the appearance of lithium nephropathy at magnetic resonance (MR) imaging.

MATERIALS AND METHODS: Sixteen patients with renal insufficiency and clinical and laboratory evidence of nephropathy secondary to therapy with lithium salts were examined with a 1.5-T MR imaging unit with T1-weighted, T2-weighted fast imaging with steady-state precession (true FISP), rapid acquisition with relaxation enhancement, half-Fourier turbo spin-echo, and gadolinium-enhanced (FISP three-dimensional MR angiographic) sequences. Renal size and the presence, number, location and size of parenchymal cysts were analyzed. The cysts in each kidney were defined as rare (fewer than 10 cysts), sparse (between 10 and 30 cysts), abundant (30–60 cysts), or very abundant (more than 60 cysts).

RESULTS: The mean length of both kidneys was 104 mm ± 9 in seven cases, and one or both kidneys were less than 90 mm in length in nine cases. Renal microcysts measuring from 1 to 2 mm were detected in all patients. They were either very abundant (n = 12), abundant (n = 2), or sparse (n = 2). The cysts were located with equal abundance in both the cortex and the medulla in 11 cases and were predominantly located in the renal cortex in five cases. No renal artery stenosis was present.

CONCLUSION: Microcysts secondary to long-term lithium therapy can be detected with MR imaging.

© RSNA, 2003

Index terms: Diabetes insipidus, 81.699 • Kidney, cysts, 81.3119 • Kidney, effects of drugs on, 81.64 • Kidney, MR, 81.12141, 81.12142




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