Static and Functional MR Urography to Assess Congenital Anomalies of the Kidney and Urinary Tract in Infants and Children: Comparison With MAG3 Renal Scintigraphy and Sonography

Rodigas, Jessica; Kirsch, Hanne; John, U; Seifert, Philipp; Winkens, Thomas; Stenzel, Martin; Mentzel, Hans‐Joachim

doi:10.2214/ajr.17.17891

Cited by 18 publications

(18 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Dynamic renal scintigraphy (DRS) is the current gold standard technique to evaluate obstruction (by drainage curve) and to measure the split renal function (SRF) between the two kidneys in children and young adults (4,5), driving therapeutic decisions. Functional Magnetic Resonance (MR) urography has been recently proposed by many study groups as an alternative technique to evaluate the drainage curve and SRF in obstructive uropathy in the last decade (6)(7)(8)(9)(10). Currently Functional MR urography is becoming established within clinical practice as it provides a depiction of deep anatomical details thanks to its intrinsically high soft-tissue contrast (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Comparative Study Between Functional MR Urography and Renal Scintigraphy to Evaluate Drainage Curves and Split Renal Function in Children With Congenital Anomalies of Kidney and Urinary Tract (CAKUT)

Damasio

Bodria

Dolores³

et al. 2020

Front. Pediatr.

View full text Add to dashboard Cite

Background: Obstructive congenital anomalies of the kidney and urinary tract have a high risk of kidney failure if not surgically corrected. Dynamic renal scintigraphy is the gold standard technique to evaluate drainage curves and split renal function (SRF).Objectives: To compare functional magnetic resonance (MR) urography with dynamic renal scintigraphy in measuring volumetric SRF and in the classification of drainage curves in patients with congenital anomalies of the kidney and urinary tract. Materials and Methods:We retrospectively collected patients with hydroureteronephrosis or pelvicalyceal dilatation at renal ultrasound, who underwent both functional MR urography and dynamic renal scintigraphy (DRS) within 6 months. DRS studies were evaluated by a single nuclear medicine physician with a double reading. Functional MR urography renograms were blind evaluated twice by two radiologists. The functional MR urographyintra-and inter-reading agreements as well as the agreement between the two imaging techniques were calculated. SRF was evaluated by Area Under the Curve and Rutland-Patlak methods. Drainage curves were classified as normal, borderline or accumulation patterns by both the techniques.Results: Fifty-two children were studied, 14 with bilateral involvement. A total of 104 kidney-urinary tracts were considered: 38 normal and 66 dilated. Considering Area Under the Curve and Rutland-Patlak for SRF, the intra-and inter-reader agreements of functional MR urography had excellent and good results, respectively, and the two techniques demonstrated a good concordance (r2: 67% for Area Under the Curve and 72% for Rutland-Patlak). Considering drainage curves, the inter-readers agreement Damasio et al. fMRU vs DRS in Children for functional MR urography and the concordance between the two techniques were moderate (Cohen's k, respectively, 55.7 and 56.3%).Conclusions: According to our results, there are no significant differences between functional MR urography and DRS in measuring volumetric SRF and in the classification of drainage curves in patients with congenital anomalies of the kidney and urinary tract.Keywords: obstructive uropathy, dynamic renal scintigraphy, functional magnetic resonance urography, congenital anomalies of the kidney and urinary tract, CAKUT

show abstract

Section: Introductionmentioning

confidence: 99%

Comparative Study Between Functional MR Urography and Renal Scintigraphy to Evaluate Drainage Curves and Split Renal Function in Children With Congenital Anomalies of Kidney and Urinary Tract (CAKUT)

Damasio

Bodria

Dolores³

et al. 2020

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…Functional MRI as alternative may provide advantages compared to US and scintigraphy regarding spatial resolution especially in complex anatomical variants but is more competitive to Tc-99m-MAG3 scintigraphy. It proved to be less accurate in determination of partial function with respect to patients with major renal impairment [22]. Radiation exposure due to DMSA scan is unfavorable but low, being approximately 1 mSv [11].…”

Section: Discussionmentioning

confidence: 99%

DMSA-camSPECT/US fusion imaging of children’s kidneys – Proof of feasibility

et al. 2019

Self Cite

View full text Add to dashboard Cite

Aim SPECT using Tc-99m-dimercaptosuccinic acid (DMSA-camSPECT) and ultrasound (US) are useful diagnostic modalities in pediatric nephrology. Former studies proved SPECT/US fusion to be a problem-solving tool for thyroid and sentinel lymph node imaging. The purpose of this study was to demonstrate the feasibility of real-time DMSA-camSPECT/US fusion in children and to evaluate the technical implementation. Methods Subsequent to a clinical indicated DMSA-camSPECT showing a mostly normal result, 10 children received a SPECT/US fusion. The magnetic sensor-navigated equipment allows a real-time superposition of three-dimensional SPECT data to live US images according to the position of the transducer. Results 100 % of still images and 90 % of cine-loops were sufficient to depict the kidney; at least one sufficient camSPECT/US fusion loop could be accomplished for every kidney examined. Limitations are mainly caused by standard difficulties of conventional US. Conclusion Real-time DMSA-camSPECT/US is feasible in depiction of renal parenchyma. This newly implemented application broadens the scope of SPECT/US fusion imaging.

show abstract

“…Although MRU is not routinely recommended in the initial workup of antenatal hydronephrosis, some authors have argued that it can add value through improved anatomical imaging, for example, in the evaluation of hydronephrosis in the setting of atypical urinary tract anatomy, such as certain duplicated collecting systems or renal dysgenesis [74]. MRU can also adequately assess degree of obstruction [75]. One potential limitation of MRU is that there are systematic differences in estimation of split renal function compared with the gold standard MAG-3 renal scan in kidneys with severely diminished renal function [75] and kidneys with severe hydronephrosis [76].…”

Section: Mag3 Renal Scanmentioning

confidence: 99%

“…MRU can also adequately assess degree of obstruction [75]. One potential limitation of MRU is that there are systematic differences in estimation of split renal function compared with the gold standard MAG-3 renal scan in kidneys with severely diminished renal function [75] and kidneys with severe hydronephrosis [76].…”

Section: Mag3 Renal Scanmentioning

confidence: 99%

ACR Appropriateness Criteria® Antenatal Hydronephrosis–Infant

Brown

Simoneaux

Dillman

et al. 2020

Journal of the American College of Radiology

View full text Add to dashboard Cite

Antenatal hydronephrosis is the most frequent urinary tract anomaly detected on prenatal ultrasonography. It occurs approximately twice as often in males as in females. Most antenatal hydronephrosis is transient with little long-term significance, and few children with antenatal hydronephrosis will have significant obstruction, develop symptoms or complications, and require surgery. Some children will be diagnosed with more serious conditions, such as posterior urethral valves. Early detection of obstructive uropathy is necessary to mitigate the potential morbidity from loss of renal function. Imaging is an integral part of screening, diagnosis, and monitoring of children with antenatal hydronephrosis. Optimal timing and appropriate use of imaging can reduce the incidence of late diagnoses and prevent renal scarring and other complications. In general, follow-up neonatal ultrasound is recommended for all cases of antenatal hydronephrosis, while further imaging, including voiding cystourethrography and nuclear scintigraphy, is recommended for moderate or severe cases, or when renal parenchymal or bladder wall abnormalities are suspected.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current

show abstract

Static and Functional MR Urography to Assess Congenital Anomalies of the Kidney and Urinary Tract in Infants and Children: Comparison With MAG3 Renal Scintigraphy and Sonography

Cited by 18 publications

References 38 publications

Comparative Study Between Functional MR Urography and Renal Scintigraphy to Evaluate Drainage Curves and Split Renal Function in Children With Congenital Anomalies of Kidney and Urinary Tract (CAKUT)

Comparative Study Between Functional MR Urography and Renal Scintigraphy to Evaluate Drainage Curves and Split Renal Function in Children With Congenital Anomalies of Kidney and Urinary Tract (CAKUT)

DMSA-camSPECT/US fusion imaging of children’s kidneys – Proof of feasibility

ACR Appropriateness Criteria® Antenatal Hydronephrosis–Infant

Contact Info

Product

Resources

About