How common is bright kidney crest on dog CT scans

Abstract

Normal canine kidneys are relatively homogeneous soft tissue attenuating structures on nonenhanced CT images. However, visible differences in attenuation between the renal crest and medulla are occasionally observed. This finding and its potential clinical implications have not been previously investigated. This study aimed to estimate the prevalence of renal crest hyperattenuation (RCH) and investigate possible associations with signalment and laboratory parameters. Abdominal CT studies from 100 dogs, with biochemistry and urinalysis data obtained within 48 h before the CT acquisition, were categorized by two radiologists into those with and without visible RCH. The attenuation in Hounsfield units (HU) of the renal crest and renal medulla were measured. Signalment, biochemical, and urinalysis data were analyzed for associations with RCH. Correlation coefficients were calculated for measured HU and associated continuous parameters. Prevalence of RCH was 42.42% (42/99 dogs, 95% CI, 33-52%). Urinary specific gravity (USG) was significantly different between dogs with and without RCH (P = .034). Weak positive correlations were identified between left and right renal crest attenuation and USG (r = 0.233 and 0.253, respectively; P = .05). Renal crest hyperattenuation is a common finding in dogs undergoing abdominal CT. Although the correlation between the USG and renal crest HU is weak, the dogs with RCH have significantly higher USG. Renal crest hyperattenuation might, therefore, not be associated with renal insufficiency. No other specific associations of RCH were identified with parameters typically altered in a variety of diseases. Further investigation may be warranted for its relevance to specific diseases or if it indeed represents a physiological variant.