Renal corticomedullary differentiation: observation in patients with differing serum creatinine levels.

PURPOSE To evaluate renal corticomedullary differentiation (CMD) in patients with differing serum creatinine (sCr) levels. MATERIALS AND METHODS Ten patients with normal sCr levels (0.9-1.3 mg/dL [80-115 mumol/L]), 14 with mildly elevated levels (1.5-2.9 mg/dL [133-256 mumol/L]), and 15 with elevated levels (> 3.0 mg/dL [265 mumol/L]) were examined with unenhanced T1-weighted fat-suppressed spin-echo (T1FS) and immediate gadolinium-enhanced gradient-echo (Gd-GRE) imaging. RESULTS Patients with normal sCr levels had CMD on T1FS and Gd-GRE images. Among patients with mildly elevated levels, seven did and seven did not have CMD on T1FS images; all had CMD on Gd-GRE images. Patients with elevated levels had no CMD on T1FS images; 13 had CMD on Gd-GRE images. Two patients with levels above 10.0 mg/dL (884 mumol/L) had no CMD on Gd-GRE images. CONCLUSION Independent of the cause of elevated sCr level, levels above 3.0 mg/dL result in loss of CMD on T1FS images, while levels above 10.0 mg/dL result in loss of CMD on Gd-GRE images.