Magnetic resonance urography in children - when and why?

Abstract

BackgroundThe aim of the study was to determine the potential of magnetic resonance urography (MRU) in evaluation of paediatric urinary tract pathologies.Patients and methods.Twenty-one paediatric urological patients were evaluated with T1, T2 prior and after and 3D gradient echo sequences after the contrast administration. Results were compared with findings obtained with ultrasound which was performed to all of patients, intravenous urography performed to 14 patients with the diagnosis of hydronephrosis and voiding cystouretrography performed to 6 patients where hydronephrosis was suspected to be caused by vesicoureteral reflux (VUR).ResultsMRU not only established the cause of hydronephrosis in all 14 cases (5 ureteropelvic junction (UPJ) stenosis, 1 functional stenosis, 3 residual hydronephrosis, 1 combination of UPJ and vesico-ureteric junction (VUJ) stenosis with hydromegaureter, 2 fetal ureters and 3 insufficient broad ureteral orifices), but gave additional information about existing pathological conditions in all of patients compared to other previously performed examination (1 caliceal lithiasis, 4 UPJ stenosis, 1 VUJ stenosis, 1 neurogenic bladder, 1 hypotonic ureter, 1 urinary infection, 1 duplication of pelvis and ureter, 1 urinary retention and 1 fetal ureter). Other MRU findings were: 3 polycystic kidney disease, 1 caliceal cyst, 2 simple renal cysts, 1 long hypotonic twisted ureters and 1 hypertrophied column of Bertini.ConclusionsBecause of the ability to acquire high contrast and spatial resolution images of the whole urinary tract in any orthogonal plane, MRU enables a precise detection and differentiation of pathological urological conditions. We believe that in the future, because of its advantages, MRU will replace traditional methods in the evaluation of urinary tract pathologies.

Antenatal Diagnosis of Cloacal Dysgenesis Sequence by Fetal Magnetic Resonance Urography: Is It Incompatible with Fetal Life?

“…There has been a striking development in diagnostic protocol of FMRU within the last seven years (Vegar-Zubovic, Kristic & Lincender 2011). Urological pathologies can be noticeably detected and differentiated by the application of FMRU (Vegar-Zubovic, Kristic & Lincender 2011), which is a non invasive and feasible method in diagnosis of dilated urinary system, in both neonates and fetuses.…”

Agreement between static magnetic resonance urography and diuretic renal scintigraphy in patients with ureteropelvic junction obstruction after pyeloplasty

“…In addition, because of its high resolution, its diagnostic sensitivity can be reached to 96% for evaluation of urogenital anomalies. [ 15 16 17 18 ] The present study aimed to compare the diagnostic value of static MRU and DRS in patients with UPJO after pyeloplasty.…”

Assessing renal function in children with hydronephrosis - additional feature of MR urography

“…MRU is a promising method for early diagnosis, having an impact on the management of congenital malformations and other urogenital anomalies in children 1. This diagnostic modality provides a detailed visualization of various morphologic abnormalities of the genitourinary system and avoids radiation, which is mutagenic 1,2. To avoid ionizing radiation is one of the most important diagnostic approaches in children 3…”

“…Currently, MRI is used in paediatrics for assessment of the congenital abnormalities of the genitourinary system, different cases of obstruction of the excretory system and evaluation of renal tumours, which are prevalent solid tumours in infants 1,4. In addition to the morphological imaging, MRI can be used to quantify the renal function.…”

“…In addition to the morphological imaging, MRI can be used to quantify the renal function. Following contrast administration and using appropriate software, time-intensity curves can be generated and other parameters ( e.g ., renal transit times, renal volumes and differential renal function) can be quantified 1. This is the reason some authors to define MRI as a potential “one-stop-shop” imaging technique for a variety of renal diseases 6–8…”