MR Urography in the Diagnosis of Urinary Tract Obstruction

Louca, G.; Liberopoulos, K.; Fidas, A.; Nikolakopoulou, Z.; Lykourinas, M.; Strigaris, Kyriakos

doi:10.1159/000019827

Cited by 44 publications

(25 citation statements)

References 14 publications

(16 reference statements)

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“…[21] dMRI with urography demonstrated 100% sensitivity in locating the upper urinary tract obstruction. [22] MRU has also been used to evaluate the results of pyeloplasty. [23] Bhat et al [24] in their study of 40 patients with PUJO, found that MRU depicted morphology accurately in 39 out of 40 patients (97.5%) and showed a close correlation between isotope renogram GFR and MRU GFR values (p<0.0001).…”

Section: Discussionmentioning

confidence: 99%

Dynamic MRI and isotope renogram in the functional evaluation of pelviureteric junction obstruction: A comparative study

Sivakumar

Indiran

Sathyanathan

2018

Turkish Journal of Urology

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Cite this article as: : Sivakumar V, Indiran V, Sathyanathan BP. Dynamic MRI and isotope renogram in the functional evaluation of pelviureteric junction obstruction: A comparative study. Turk J Urol 2018; 44(1): 45-50. ORCID IDs of the authors:V.N.S. 0000-0002-5254-8559; V.I. 0000-0001-5296-0175; B.P.S. 0000-0002-4057-0054. ABSTRACTObjective: The aim of this study was to evaluate and compare the diagnostic accuracy of dynamic contrast-enhanced magnetic resonance imaging (dMRI) and isotope renogram in the functional evaluation of pelviureteric junction obstruction (PUJO). Material and methods:Forty-two patients included in the study were investigated with isotope renogram and subsequently, subjected to dMRI. Time-activity curves were generated for both isotope renogram and dMRI. Out of the 42 cases, 9 cases were conservatively managed. Thirty-three cases were taken up for surgical intervention.Results: Of 33 patients taken up for surgical intervention, 12 underwent laparoscopic nephrectomy and 21 of them pyeloplasty. The mean glomerular filtration rates (GFRs) as measured by isotope renogram and dMRI were 22.5+4.2 mL/min and 23.8+3.1 mL/min respectively. The calculation of GFR by isotope renogram, showed good correlation with that of dMRI with correlation coefficient of 0.93. The dMRI was able to reveal the functional status of the renal unit accurately. dMRI did not yield false positive results with 20 of 21 patients scheduled for pyeloplasty and 11 of 12 patients scheduled for nephrectomy. Isotope renogram had a false positive result in 3 cases compared with surgical diagnosis. Conclusion:Analysis of renal function using dMRI yielded results comparable to those of renal scintigraphy, with superior spatial and contrast resolution. It was also better in prompting management decisions with respect to the obstructed systems. dMRI can be used as a "one stop imaging examination" that can replace different imaging methods used for morphological, etiological and functional evaluation of PUJO.

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Section: Discussionmentioning

confidence: 99%

Dynamic MRI and isotope renogram in the functional evaluation of pelviureteric junction obstruction: A comparative study

Sivakumar

Indiran

Sathyanathan

2018

Turkish Journal of Urology

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“…[10][11][12][13] In this report, we propose a protocol for MR urography that provides functional information such as split renal function, which can easily be obtained from the dynamically acquired single-slice 2D data sets. Furthermore, urinary excretion into the ureter can be assessed dynamically by computation of signal-intensity-time curves.…”

Section: Discussionmentioning

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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“…Magnetic resonance urography is a powerful diagnostic tool, especially in children with obstructive uropathy [2]. Early recognition and treatment of urological anomalies in a child with URA are imperative to reduce the longterm risk of contralateral kidney damage [1].…”

Section: Discussionmentioning

confidence: 99%