MR urography in children: current status and future development

Borthne, Arne; Pierre-Jerome, Claude; Nordshus, T; Reiseter, Tor

doi:10.1007/s003300050085

Cited by 51 publications

(38 citation statements)

References 24 publications

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“…The results achieved in the studies performed to evaluate MR urography and renal function numerically in literature are towards the possibility that it can be the alternative of the diuretic renal scintigraphy (Borthne et al, 2000;Avni et al, 2002;Rohrschneider et al, 2002;Zielonko et al, 2003). A dynamic MR urography technique that enables the calculation of single kidney function similarly with the scintigraphy was used in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover VSUG in the diagnosis of vesicouretheral reflux (VUR) and diuretic real scintigraphy in the evaluation of renal functions are the monitoring methods applied. MR urography is a monitoring method relatively new in comparison to others and a preferred one as it presents accurate anatomic information and functional data, does not include ionized radiation and for the wide safety range of the contrast agent used and the obtainment of quick images (Borthne et al, 2000;Hwang et al, 2000;Rohrschneider et al, 2000a, Rohrschneider et al, 2000bZielonko et al, 2003). In this study, the morphological and functional diagnostic characteristics of MR urography, US and diuretic renal scintigraphy were discussed on the pediatric patients which were diagnosed with complex urinary system abnormalities and collecting system dilatation by US in our clinic.…”

Section: Discussionmentioning

confidence: 99%

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Magnetic resonance urography in the assesment of congenital urinary system dilatation in pediatric patients

Kılınç¹,

Subaşi²,

Kaya³

2013

jecm

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Article HistoryReceived 04 / 05 / 2013 Accepted 21 / 05 / 2013The aim of this study is to assess combined static-dynamic magnetic resonance (MR) urography in the evaluation of urinary tract anomalies in infants and children. Thirthynine patients with urinary tract anomalies underwent retrospective examination between 2009-2012, with combined static-dynamic MR urography. A combination examination involved use of a static T2-weighted thick slap spin-echo sequence and a dynamic T1-weighted tree-dimensional spoiled gradient-echo-recalled sequence with gadopentetate dimeglumine-DTPA and furosemide application. Morphologic results were compared with those of ultrasonography and, when available, surgery. The dynamic sequence was used to calculate renal transit time (RTT), split renal function from renograms generated from parenchymal regions of interest and to assess urinary excretion from whole-kidney renograms. Results were compared with those of diuretic renal scintigraphy for split function and urinary excretion. Urinary system dilatations caused by stenosis at the ureteropelvic (n=16), ureterovesical (n=4) junctions and within the ureter (n=6), posterior urethral valve (n=1), postoperative urethral obstruction (n=1), neurogenic bladder (n=1) and nonstenotic dilatation (n=4) and urinary tract anomalies, double collecting system (n=4) and isolated urinary tract anomalies (n=2) were clearly depicted. For morphologic evaluation, sensivity of MR urography compared with surgery calculated 82.75% and for split renal function, sensivity of dynamic MR urography compared with diuretic renal scintigraphy (DRS) calculated 80%. For urinary excretion, MR urography and DRS showed strong agreement. MR urografi is a modality with which urinary system pathologies could be both morphologically and functionally evaluated with high accuracy and does not use ionizing radiation. But it has disadvantages for example, children need sedation during examination, results cannot be compared with enough clinical trials because of ethical reasons and some technical incapabilities. But we think with some technical improvements, MR urography can be applied in diagnosis and follow up of urinary system abnormalities in children with high degree of confidency.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Magnetic resonance urography in the assesment of congenital urinary system dilatation in pediatric patients

Kılınç¹,

Subaşi²,

Kaya³

2013

jecm

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“…Using fast heavily T2-weighted (3D) sequences with breathhold or diaphragmatic triggering, the (dilated) pelvocalyceal system and ureter can be exquisitely demonstrated; note that previous hydration as well as the administration of furosemide is essential for an optimal fi lling (Sigmund et al 1991 ;Nolte-Ernsting et al 2001, 2003Borthne et al 2000Borthne et al , 2003Grattan-Smith and Jones 2006 ). Additionally, gadolinium (Gd) can be administered intravenously which then allows the assessment of renal and vascular anatomy, renal parenchymal contrast uptake, as well as excretion and drainage of Gd in a single nonionizing investigation; this investigation has practically replaced IVU for most pediatric queries (Avni et al 2002 ;Caldair et al 2007 ;Riccabona et al 2002bRiccabona et al , 2004bPerez-Brayfi eld et al 2003 ;Rohrschneider et al 2003 ;Boss et al 2006 ;Riccabona et al 2004b ).…”

Section: Obstructive Uropathymentioning

confidence: 99%

The Pediatric Kidney

Riccabona

2014

Radiological Imaging of the Kidney

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Children are not small adults. In the urinary tract, particularly, there are many conditions that are more or less specifi c to children which need early and reliable diagnosis in order to provide proper treatment to prevent renal damage and severe long-term sequelae such as hypertension or renal insuffi ciency. This is particularly important for all congenital urinary tract malformations and also for many other congenital renal conditions -these are often detected prenatally and, after birth, need prompt and reliable diagnostic workup at minimal invasiveness. Additionally, even in conditions that are the same or similar to adults, the specifi c needs and conditions in childhood require different imaging approaches and algorithms, partially because of each of the following reasons: the child's higher sensitivity to radiation, different physiology, different size and imaging appearance, as well as different potential of the various imaging techniques. These differences are outlined, focusing on some important diseases and queries such as congenital hydronephrosis and obstructive uropathy, impact of vesicoureteral refl ux on the kidney, imaging in infants with urinary tract infection, childhood urolithiasis and nephrocalcinosis, pediatric renal masses, as well as other miscellaneous renal conditions that may manifest in the child and indicate imaging. Additionally, specifi c needs for adapting and applying the various imaging techniques in childhood are discussed.

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“…Magnetic resonance urography is gaining popularity as an alternative technique of urinary tract imaging in a wide range of clinical settings [1,2,3,4,5,6,7,8,9,10,11,12,13,14]. The introduction of heavily T2-weighted very fast-spin-echo sequences, such as rapid acquisition with relaxation enhancement (RARE), half-Fourier acquisition single-shot turbo spin echo (HASTE) and similar modifications, allowed high-quality MRU and reduced breathing-related artefacts [1,2,3,4,5].…”

Section: Introductionmentioning

confidence: 99%

Filling defect artefacts in magnetic resonance urography

2004

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The aim of this study was to determine the prevalence of filling defect artefacts (FDA) in magnetic resonance urography (MRU). Retrospectively, we assessed MRU examinations of 45 patients with neurogenic bladder dysfunction (21 men, 24 women; mean age 35 years, age range 18-71 years). The MRU was performed 30 min after intramuscular injection of 20 mg frusemide using heavily T2-weighted fast-spin-echo techniques [axial, thick coronal slab, coronal maximum intensity projection (MIP) images] with fat saturation. The images were reviewed by two observers to determine the presence of filling defects and dilatation of pelvicalyceal system and ureters. The filling defects were classified into central, eccentric and complete. Clinical course and plain films were reviewed to determine significance of the detected filling defects. True filling defects were observed in 5 patients (11%) and all due to stones seen on the plain radiograph of the abdomen. Filling defects artefacts (FDAs) were seen in 23 patients (51%; 17 pelvicalyceal system, 17 upper third of ureters, 7 mid ureters and 1 distal ureter). No stones were seen on the plain radiograph of these patients and they had a favourable clinical course for over 24 months. The true filling defects were large in size, eccentric in position and seen in more than one sequence of the MRU examination (axial, n=5; slab, n=5; and MIP, n=4). Four (80%) of the patients with true defects and 21 (91%) of those with FDAs had dilatation of the pelvicalyceal system and ureters. The FDAs were small in size, centrally placed (74%) and always seen in axial images, rarely in slab images (2 cases) and not seen in MIP images. Artefactual filling defects can be seen in MRU examinations. The cause of the FDAs is not fully explained and could be secondary to turbulent and fast flow of the urine. Some of the FDAs seen in the calyces could be due to the tips of the papillae. Awareness of such defects obviates misinterpretation and prevents unnecessary further investigations or interventions.

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MR urography in children: current status and future development

Cited by 51 publications

References 24 publications

Magnetic resonance urography in the assesment of congenital urinary system dilatation in pediatric patients

Magnetic resonance urography in the assesment of congenital urinary system dilatation in pediatric patients

The Pediatric Kidney

Filling defect artefacts in magnetic resonance urography

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