Kidney TransplantationRelationship between steroid dosage and osteonecrosis of the femoral head after renal transplantation as measured by magnetic resonance imaging☆
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Subjects and methods
Subjects were 45 patients (30 males and 15 females) who underwent renal transplantation at the ages of 18 to 62 years (mean, 33.5 years) in the Second Department of Surgery, Kyoto Prefectural University of Medicine, and who had a good postoperative course and have received MRI screenings from the early postoperative period. MRI was performed using a 0.5 or 1.5 Tesla superconducting magnet to make cross-sectional images on the coronal plane. T1 (TR: 500 ms, TE: 30 ms) and T2 (TR: 2000 ms, TE: 80
Results
ONF confirmed by characteristic abnormalities (band patterns) on MRI was found in 12 of the 45 patients (26.7%), and 9 of them had bilateral ONF. ONF was first detected on average 4.5 months after transplantation and the earliest timing was 6 weeks after surgery. In the 12 patients who developed ONF, the mean dose of oral steroids was 1232 mg during the first month, and 1936 mg during the first and the second months; the total dose of IV methylprednisolone was 1687 mg during the 2 months. In
Discussion
In the present study, the frequency of ONF was 26.7% (12 of 45 patients). This rate was higher than those reported in other studies using simple radiography.2, 3 The possible reason for this difference is the higher sensitivity of MRI for ONF, which might be clinically and radiologically undetectable.
Our previous study demonstrated that (1) MRI can detect ONF at an early time, and (2) ONF could occur quite early in the postoperative period.1 In the present study, ONF was first detected on
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This study received grant support from the Ministry of Health and Welfare of Japan.