MR imaging of kidneys: functional evaluation using F-15 perfusion imaging

Grattan‐Smith, J. Damien; Perez-Bayfield, Marcos R.; Jones, Richard A.; Little, Stephen B.; Broecker, Bruce H.; Smith, Edwin A.; Scherz, Hal C.; Kirsch, Andrew J.

doi:10.1007/s00247-003-0896-7

Cited by 108 publications

(56 citation statements)

References 29 publications

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“…Identification of VUR is important because children with concurrent VUR and PUJ obstruction may be at higher risk for severe infection. Magnetic Resonance Imaging (MRI) with urography is being investigated to define urinary tract anatomy, calculate differential renal function, and assess urinary tract obstruction [8].…”

Section: Discussionmentioning

confidence: 99%

Profile and Outcome of Pelviureteric Junction Obstruction

Senguttuvan

Jigy²

2014

TOUNJ

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Abstract:Obstructive uropathy represents one of the largest fractions of identifiable causes of renal failure in pediatric populations. This is one of the largest series of PUJ obstructions reported in children. PUJ obstruction is a relatively common congenital anamolyes in neonates and children and a cause of ESRD in developing countries. This series expands our knowledge about the clinical presentation and course of this disease. Pelviureteric junction (PUJ) obstruction is a partial or total blockage of the flow of urine that occurs where the ureter enters the kidney and is the most common cause of significant dilatation of the collecting system in the fetal kidney. We retrospectively analyzed children diagnosed as PUJ obstruction between the periods of 2008-2010 who presented to our institute. Forty four children were diagnosed to have PUJ obstruction. The median age at presentation was 11 months, with range of 3 months to 11 years. Male children constituted 34 (77.3%) cases. Unilateral PUJ with left sided involvement was more common (52.3%). Antenatal diagnosis was made in 18 (40.9%) cases. The common clinical presentations were fever, urinary tract infection (UTI) and abdominal pain. Hypertension was present in five (11.3%) patients and renal failure at presentation was seen in eight (18.2%) patients. Associated urogenital anomalies were present in twelve (27.3%) patients, with medullary cystic kidney disease (MCKD) being the most commonassociated anomaly. Prophylactic antibiotics were not prescribed to patients. Urinary tract infection was present in fourteen (31.9%) patients with E. coli being the most common organism (75%). Conservative management with regular follow up was done for 32 patients and the remaining twelve patients underwent pyeloplastyin view of gross hydronephrosis, and four (33.3%)of these patients later underwent nephrectomy for a nonfunctioning kidney. Antenatal screening is mandatory to make an early diagnosis and for further management and close follow upof PUJ obstruction. Randomized control trials and longer follow up studies are needed for evidence to suggest the optimal management.

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Section: Discussionmentioning

confidence: 99%

Profile and Outcome of Pelviureteric Junction Obstruction

Senguttuvan

Jigy²

2014

TOUNJ

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“…It is the lack of our study that single kidney GFR could not be calculated because of technical insufficiencies. Some previous studies reported that DRF on MRU was in correlation with SRF on DRS (4,5) . We have also determined a significant correlation between DRF and SRF, and our data suggest that each procedure is useful in the determination of renal function.…”

Section: Discussionmentioning

confidence: 88%

“…Superior spatial and contrast resolution is achieved with dynamic contrast enhanced MRU compared to that of USG or DRS (4). Analysis of renal function with MRU is comparable to that of DRS (4,5). The quality of dynamic MR images enables additional functional parameters to be derived, such as renal transit time (RTT) (6).…”

Section: Introductionmentioning

confidence: 99%

The comparison of magnetic resonance urography with the combination of diuretic renal scintigraphy and urinary ultrasound in the diagnosis and follow up of ureteropelvic junction obstruction

et al. 2015

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Objectives: To evaluate the efficiency and reliability of MRU in diagnosis and follow up of children with UPJO. Methods: The data of 64 patients with the diagnosis of primary UPJO were analysed. All patients underwent Anderson-Hynes pyeloplasty and pelvic reduction. Pre and postoperative results of renal pelvis AP diameter (RPAPD), separated renal function, renal transit time (RTT), and anatomical findings in USG and renal scintigraphy were compared with MRU findings to evaluate the possible differences and analyse the efficiency and reliability of MRU in the management of UPJO. Results: All patients had unilateral hydronephrosis including 16 grade 2, 24 grade 3 and 24 grade 4. Pre-and postoperative RPAPDs in two techniques were also similar (P = 0.084, P = 0.576). Separated renal functions were evaluated by MRU with similar and sensitivity in DRS (P = 0.867). The comparison of mean pre and postoperative RTT results showed a significant improvement in mean postoperative RTT value (P = 0.024). Conclusions: MRU has the potential to become the imaging study of choice in the diagnosis and follow up of obstructive uropathy, and it may have a more significant role in the management of UPJO in the near future.

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“…[3][4][5][6][7] One disadvantage of these conventional gradient-echo sequences regarding applications in young children is, however, the relatively long acquisition time of approximately 5-15 s resulting in breathing artefacts. In this study, we evaluate a protocol applying a singleshot TurboFLASH sequence with an acquisition time of only 0.5 s, which can be combined with a navigator-triggering technique providing images at virtually identical diaphragm positions.…”

Section: Advances In Knowledgementioning

confidence: 99%

Dynamic MR urography in children with uropathic disease with a combined 2D and 3D acquisition protocol—comparison with MAG3 scintigraphy

Boss¹,

Martirosian²,

Fuchs³

et al. 2014

The British Journal of Radiology

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Objective: The aim of this study was to evaluate combined two-dimensional (2D) and three-dimensional (3D) dynamic MR urography with respiratory compensation in children with anomalies of the genitourinary tract, allowing for computation of split renal function and assessment of urinary tract obstruction. Methods: Dynamic MR urography was performed in 53 children (3 months-16 years of age) with anomalies of the urinary tract. A protocol for dynamic MR urography and nephrography was implemented at 1.5 T using a navigator-triggered 2D TurboFLASH sequence. Split renal function and contrast-medium excretion were assessed after the bolus injection of 0.05 mmol kg 21 body weight of gadolinium dimeglumine. In the excretory phase, a 3D gradientecho data set with high spatial resolution was acquired. In all patients, mercaptoacetyltriglycine (MAG3) scintigraphy was obtained as a reference standard.Results: In all children, dynamic MR nephrography and urography could be performed with excellent compensation of breathing artefacts providing region of interest analysis in nearly identical kidney positions. The assessment of contrastmedium excretion into the ureter allowed for discrimination of functional from non-functional stenosis. Split renal function assessed by MRI showed an excellent agreement with the MAG3 reference standard with a correlation coefficient r 5 0.95. Additionally recorded 3D data sets offered good depiction of anatomical anomalies in all patients. Conclusion:The proposed protocol provides a robust technique for assessment of ureteral obstruction and split renal function with compensation of breathing artefacts, short post-processing time and excellent 3D spatial resolution. Advances in knowledge: The combined protocol of 2D and 3D MR urography is an efficient technique for assessment of renal morphology and function.

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MR imaging of kidneys: functional evaluation using F-15 perfusion imaging

Cited by 108 publications

References 29 publications

Profile and Outcome of Pelviureteric Junction Obstruction

Profile and Outcome of Pelviureteric Junction Obstruction

The comparison of magnetic resonance urography with the combination of diuretic renal scintigraphy and urinary ultrasound in the diagnosis and follow up of ureteropelvic junction obstruction

Dynamic MR urography in children with uropathic disease with a combined 2D and 3D acquisition protocol—comparison with MAG3 scintigraphy

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