Roque Andreia, Herédia Vasco, Ramalho Miguel, de Campos Rafael, Ferreira Ana, Azevedo Rafael, Semelka Richard
Department of Radiology, University of North Carolina, Chapel Hill, USA.
Abdom Imaging. 2012 Feb;37(1):140-6. doi: 10.1007/s00261-011-9745-6.
To describe MR features of the kidney in patients on chronic lithium therapy and to correlate findings with the level of renal impairment.
In this retrospective HIPPA compliant study, a search was performed in our institutional clinical and radiological computerized database for subjects with lithium-related kidney disease between August 1, 2009 and May 30, 2010. Four patients (2 male and 2 females, mean age 64.75 ± 3.5) with a total of eight kidneys fulfilled the search criteria. T2-weighted images were used to evaluate the presence, size, and distribution of renal cysts. T1-weighted images were used to evaluate kidney length, parenchymal thickness, and cortico-medullary differentiation (CMD).
All kidneys displayed multiple, very abundant, small size (1-2 mm) cysts. The distribution of the cysts was symmetric in renal cortex and medulla and the number of cysts was similar in both kidneys. Sparse, asymmetrical parenchymal renal cysts >3 mm in diameter were also observed. The size and parenchyma thickness of both kidneys was considered normal in all patients. The CMD differentiation was preserved only in patients with normal laboratory kidney findings (n = 2), but was lost in patients with chronic renal failure.
Multi-microcystic kidney disease secondary to long-term lithium therapy can be detected with MR imaging regardless of known renal impairment. Preservation of renal CMD was observed in both patients with normal kidney function. The results of our preliminary study suggest the possible role of MR imaging for the screening of early manifestations of nephropathy in patients undergoing chronic lithium therapy.
描述接受慢性锂盐治疗患者的肾脏磁共振成像（MR）特征，并将检查结果与肾功能损害程度相关联。
在这项符合健康保险流通与责任法案（HIPPA）的回顾性研究中，于2009年8月1日至2010年5月30日期间在我们机构的临床和放射学计算机数据库中搜索患有锂相关性肾病的受试者。四名患者（2名男性和2名女性，平均年龄64.75±3.5岁）共八个肾脏符合搜索标准。采用T2加权图像评估肾囊肿的存在、大小和分布。采用T1加权图像评估肾脏长度、实质厚度和皮髓质分化（CMD）。
所有肾脏均显示多个、非常丰富的小尺寸（1 - 2毫米）囊肿。囊肿在肾皮质和髓质的分布对称，且两侧肾脏的囊肿数量相似。还观察到稀疏、不对称的直径>3毫米的肾实质囊肿。所有患者的两侧肾脏大小和实质厚度均被认为正常。仅在实验室检查肾脏结果正常的患者（n = 2）中保留了CMD分化，但在慢性肾衰竭患者中丧失。
无论已知的肾功能损害情况如何，通过MR成像均可检测到长期锂盐治疗继发的多微囊性肾病。在肾功能正常的两名患者中均观察到肾CMD的保留。我们初步研究的结果提示MR成像在筛查接受慢性锂盐治疗患者肾病早期表现方面可能具有作用。
