Pseudonormal Corticomedullary Differentiation of the Kidney Assessed on T<sub>1</sub>-weighted Imaging for Chronic Kidney Disease Patients with Cirrhosis

We investigated whether corticomedullary differentiation (CMD) increased to a pseudonormal appearance on T1-weighted magnetic resonance (MR) images in patients with chronic kidney disease (CKD) with cirrhosis compared with patients with CKD without chronic liver disease.We assessed CMD on T1-weighted MR images of 32 patients with CKD with liver cirrhosis and 32 age-matched patients with CKD without liver cirrhosis, grading CMD visualization as good, moderate, or poor. We calculated quantitative CMD by the ratio of the signal intensity of the cortex to that of the medulla.The proportions of patients in each of the good, moderate, and poor groups differed significantly between those with and without liver cirrhosis (P = 0.048). In patients with CKD with liver cirrhosis, the estimated glomerular filtration rate (eGFR) differed between those with poor CMD and those with good or moderate CMD (P < 0.01) but not between those with good and those with moderate CMD. In patients with CKD without cirrhosis, the eGFR differed significantly among the good, moderate, and poor CMD groups (P < 0.05). We observed no significant correlation between CMD and eGFR in patients with and without cirrhosis (P < 0.05, r = 0.62).CMD of the kidney had a pseudonormal appearance on T1-weighted MR imaging in patients with CKD with cirrhosis.