Comprehensive MR Urography Protocol: Equally Good Diagnostic Performance and Enhanced Visibility of the Upper Urinary Tract Compared to Triple-Phase CT Urography

Sudah, Mazen; Masarwah, Amro; Kainulainen, Sakari; Pitkänen, Minna; Matikka, Hanna; Dabravolskaite, Vaiva; Aaltomaa, S.; Vanninen, Ritva

doi:10.1371/journal.pone.0158673

Cited by 36 publications

(15 citation statements)

References 22 publications

(26 reference statements)

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“…There are several techniques to improve opacification and distention of urinary tracts in CTU, including oral and intravenous hydration, use of compression belts and administration of diuretics [1, 2, 8, 20, 31, 32]. Also, reduction of contrast layering effect may result in improving diagnostic accuracy of CTU [17, 20, 33]. It is highlighted in evaluation of ureters in adults, where suboptimal distention and peristaltic waves may limit visualization of small urothelial tumors [32, 34].…”

Section: Discussionmentioning

confidence: 99%

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Influence of furosemide on contrast medium distribution in computed tomography urography of high-grade hydronephrosis in children

Bombiński

Brzewski

Warchoł

et al. 2018

Cent european J Urol

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IntroductionDiuretics improve visualization of the urinary tract in computed tomography urography in adults, as well as in magnetic resonance urography in adults and children. Also, diuretics can help to diagnose upper urinary tract obstruction in intravenous urography, ultrasonography or dynamic scintigraphy. However, there are still missing data on evaluation of furosemide usefulness in computed tomography urography examinations in children with suspected congenital anomalies of the urinary tracts.The aim of this study was to compare the homogeneity of contrast medium distribution in high-grade hydronephrosis in pediatric computed tomography urographies performed with and without use of diuretic (furosemide).Materials and methodWe have restrospectively analyzed computed tomography urography image series performed in the Department of Pediatric Radiology, in children with suspected congenital anomalies of the kidney and the urinary tract. Kidney units with high-grade hydronephrosis were divided in two groups: non-furosemide (n = 25) and furosemide (n = 28) group, where diuretic in dose 1 mg/kg, with maximum 20 mg, was administered intravenously 3–5 min before contrast medium administration. Subjective image quality and diagnostic confidence were evaluated by two independent radiologists and compared between study groups.ResultsThere were no significant differences in subjective image quality and diagnostic confidence between furosemide and non-furosemide groups.ConclusionsAddition of furosemide to computed tomography urography does not improve homogeneity of contrast medium distribution in hydronephrotic kidneys in children.

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Section: Discussionmentioning

confidence: 99%

“…However, usefulness of furosemide has been assessed in a very limited manner. Also, it is highlighted that increased diuresis caused by furosemide may increase distention of the urinary tract and reduce contrast medium (CM) concentration, resulting in decreased opacification and poorer visualization of the collecting system [17].…”

Section: Introductionmentioning

confidence: 99%

Influence of furosemide on contrast medium distribution in computed tomography urography of high-grade hydronephrosis in children

Bombiński

Brzewski

Warchoł

et al. 2018

Cent european J Urol

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“…Another study revealed that as compared to CTU, MRU is efficient in differentiating between the lower and upper poles of the kidneys [ 35 ]. As compared to CTU, MRU is likely to become the primary investigation technique in the selected patients because it does not entail exposure to radiation [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Value of Magnetic Resonance Urography Versus Computerized Tomography Urography (CTU) in Evaluation of Obstructive Uropathy: An Observational Study

Bafaraj

2017

CMIR

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Background:Obstructive uropathy is a common public health issue that requires imaging research for providing necessary information. The data is important for determining treatment options, and may influence selective management choices.Objective:The aim of the study is to determine whether magnetic resonance urography or computerized tomography urography is the best imaging modality among patients with suspected obstructive uropathy.Methods:Seventy patients; referred from the emergency department for the evaluation of renal colic or hematuria that highly suggested urinary tract abnormalities, were prospectively enrolled. Thirty five women and 35 men were categorized with a mean age of 43.52 years and the mean body weight of 61.31 kg. All participants underwent abdominal ultrasonography and clinical examination to detect the causes of urinary obstruction. Pregnant women were excluded from the study. Both magnetic resonance urography and computerized tomography urography were performed within 30 days of each analysis.Results:Only 54.3% of the participants had urinary stones. Mean size of the renal stone was 11 mm; while mean size of the ureteral stone was 3.8 mm. The approach of magnetic resonance is not only limited to diagnosis, but is also effectively involved in the real time investigations. MRU has more reliability in terms of the diagnosis and anatomic presentation of the kidneys along with the vasculature. All cases of urinary stones were detected by computed tomography (100%); whereas, 78.9% cases were detected by magnetic resonance urography.Conclusion:Computerized tomography urography is more sensitive in detecting kidney stones; whereas, magnetic resonance urography is better in detecting pathology behind the development of kidney stones.

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“…MR urography is used to image the upper tracts and is recommended by multiple guidelines as an alternative to CT urography when necessary such as the AUA, European Association of Urology (EAU), and NCCN [ 29 ]. One small prospective study of 20 patients showed equal diagnostic performance between 3T MR urography and triple phase CT urography obtained to exclude upper tract malignancy [ 29 ]. Visualization scores noted CT urography to have slightly better visualization of the intrarenal cavity and poorer visualization of the distal ureters, and MR urography showing slightly better visualization of the ureters.…”

Section: Role Of Imaging In Stagingmentioning

confidence: 99%

Imaging and Management of Bladder Cancer

Wong

Ganeshan

Jensen

et al. 2021

Cancers

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Methods: Keyword searches of Medline, PubMed, and the Cochrane Library for manuscripts published in English, and searches of references cited in selected articles to identify additional relevant papers. Abstracts sponsored by various societies including the American Urological Association (AUA), European Association of Urology (EAU), and European Society for Medical Oncology (ESMO) were also searched. Background: Bladder cancer is the sixth most common cancer in the United States, and one of the most expensive in terms of cancer care. The overwhelming majority are urothelial carcinomas, more often non-muscle invasive rather than muscle-invasive. Bladder cancer is usually diagnosed after work up for hematuria. While the workup for gross hematuria remains CT urography and cystoscopy, the workup for microscopic hematuria was recently updated in 2020 by the American Urologic Association with a more risk-based approach. Bladder cancer is confirmed and staged by transurethral resection of bladder tumor. One of the main goals in staging is determining the presence or absence of muscle invasion by tumor which has wide implications in regards to management and prognosis. CT urography is the main imaging technique in the workup of bladder cancer. There is growing interest in advanced imaging techniques such as multiparametric MRI for local staging, as well as standardized imaging and reporting system with the recently created Vesicle Imaging Reporting and Data System (VI-RADS). Therapies for bladder cancer are rapidly evolving with immune checkpoint inhibitors, particularly programmed death ligand 1 (PD-L1) and programmed cell death protein 1 (PD-1) inhibitors, as well as another class of immunotherapy called an antibody-drug conjugate which consists of a cytotoxic drug conjugated to monoclonal antibodies against a specific target. Conclusion: Bladder cancer is a complex disease, and its management is evolving. Advances in therapy, understanding of the disease, and advanced imaging have ushered in a period of rapid change in the care of bladder cancer patients.

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Comprehensive MR Urography Protocol: Equally Good Diagnostic Performance and Enhanced Visibility of the Upper Urinary Tract Compared to Triple-Phase CT Urography

Cited by 36 publications

References 22 publications

Influence of furosemide on contrast medium distribution in computed tomography urography of high-grade hydronephrosis in children

Influence of furosemide on contrast medium distribution in computed tomography urography of high-grade hydronephrosis in children

Value of Magnetic Resonance Urography Versus Computerized Tomography Urography (CTU) in Evaluation of Obstructive Uropathy: An Observational Study

Imaging and Management of Bladder Cancer

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