Skip to main content

Advertisement

SpringerLink
Log in

Application of magnetic resonance urography in diagnosis of congenital urogenital anomalies in children

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Magnetic resonance urography (MRU) has become a useful adjuvant in evaluating urogenital anomalies. In present study, we evaluated the ability of MRU in diagnosis of different congenital urogenital anomalies when the results of conventional imaging modalities were inconclusive. A total of 90 children were included in this series. The children were evaluated with T2-weighted and contrast-enhanced T1-weighted MRU sequences. The results were compared with findings obtained with ultrasonography, intravenous urography, renal nuclide scan, and voiding cystourethrography. MRU was requested in these children because conventional imaging modalities were equivocal or a co-existing urogenital anomaly was suspected. Only those cases that underwent surgery were included in this study and the surgical findings were set as the reference standard in statistical evaluation. The records of 61 boys with mean (range) age of 2.3 years (2 months–12 years) and 29 girls with mean (range) age of 3.3 years (3 months–12 years) were reviewed. The final diagnosis was ureteropelvic junction obstruction (n = 25), vesicoureteral junction obstruction (n = 16), ureterocele (n = 19), ectopic kidney (n = 11), posterior urethral valve (n = 17), and polycystic kidney (n = 2). The overall sensitivity of MRU, intravenous urography, renal nuclide scan, ultrasonography, and voiding cystourethrography in diagnosis of the aforementioned anomalies were 86, 63, 50, 44, and 41%, respectively. MRU was much more sensitive than other imaging modalities in diagnosis of end-ureteral dilation (100%) and ureterocele (89%). MRU provides a reliable noninvasive technique for imaging of the congenital anomalies in the urinary tract of children with T2-weighted MRU sequences providing unenhanced static-water images of the urinary tract as well as depicting adjacent soft-tissue lesions, and T1-weighted MRU technique imitating conventional intravenous urography. Both MRU sequences can be combined for a comprehensive examination of the urinary tract.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Avni EF, Bali MA, Regnault M, Damry N, Degroot F, Metens T et al (2002) MR urography in children. Eur J Radiol 43:154–166. doi:10.1016/S0720-048X(02)00112-2

    Article  PubMed  Google Scholar 

  2. Aydingoz U (2006) The need for radiologists’ awareness of nephrogenic systemic fibrosis. Diagn Interv Radiol 12:161–162

    PubMed  Google Scholar 

  3. Blandino A, Gaeta M, Minutoli F, Scribano E, Vinci S, Famulari C et al (2001) MR pyelography in 115 patients with a dilated renal collecting system. Acta Radiol 42:532–536. doi:10.1080/028418501127347124

    Article  PubMed  CAS  Google Scholar 

  4. Borer JG, Bauer SB, Peters CA, Diamond DA, Decter RM, Shapiro E (1998) A single-system ectopic ureter draining an ectopic dysplastic kidney: delayed diagnosis in the young female with continuous urinary incontinence. Br J Urol 81:474–478

    PubMed  CAS  Google Scholar 

  5. Borthne A, Pierre-Jerome C, Nordshus T, Reiseter T (2000) MR urography in children. Current status and future development. Eur Radiol 10:503–511. doi:10.1007/s003300050085

    Article  PubMed  CAS  Google Scholar 

  6. Boyd AS, Zic JA, Abraham JL (2007) Gadolinium deposition in nephrogenic fibrosing dermopathy. J Am Acad Dermatol 56:27–30. doi:10.1016/j.jaad.2006.10.048

    Article  PubMed  Google Scholar 

  7. Broome DR, Girguis MS, Baron PW (2007) Gadodiamideassociated nephrogenic systemic fibrosis: why radiologists should be concerned. AJR 188:586–592. doi:10.2214/AJR.06.1094

    Article  PubMed  Google Scholar 

  8. Cassart M, Massez A, Metens T, Rypens F, Lambot MA, Hall M et al (2004) Complementary role of MRI after sonography in assessing bilateral urinary tract anomalies in the fetus. Am J Roentgenol AJR 182:689–695

    Google Scholar 

  9. Cengiz M, Baysal Z, Ganidagli S (2006) Oral sedation with midazolam and diphenhydramine compared with midazolam alone in children undergoing magnetic resonance imaging. Paediatr Anaesth 16:621–626. doi:10.1111/j.1460-9592.2005.01820.x

    Article  PubMed  Google Scholar 

  10. Chu WC, Lam WW, Chan KW, Yeung CK, Lee KH, Sihoe JD (2004) Dynamic gadolinium-enhanced magnetic resonance urography for assessing drainage in dilated pelvicalyceal systems with moderate renal function: preliminary results and comparison with diuresis renography. BJU Int 93:830–834. doi:10.1111/j.1464-410X.2003.04725.x

    Article  PubMed  CAS  Google Scholar 

  11. Chu WCW, Lam WWM, Metreweli C (2000) The incidence of adverse events after MR contrast in Chinese population: a comparison between Magnevist and Omniscan. Acta Radiol 41:662–666. doi:10.1080/028418500127346108

    Article  PubMed  CAS  Google Scholar 

  12. Cowper SE, Robin HS, Steinberg SM (2000) Scleromyxoedema-like cutaneous diseases in renal-dialysis patients. Lancet 356:1000–1001. doi:10.1016/S0140-6736(00)02694-5

    Article  PubMed  CAS  Google Scholar 

  13. Dalla Palma L, Pozzi-Mucelli R, Stacul F (2001) Present-day imaging of patients with renal colic. Eur Radiol 11:931–939. doi:10.1007/s003300000801

    Article  PubMed  CAS  Google Scholar 

  14. De Sanctis Briggs V (2005) Magnetic resonance imaging under sedation in newborns and infants: a study of 640 cases using sevoflurane. Paediatr Anaesth 15:9–15. doi:10.1111/j.1460-9592.2005.01360.x

    Article  PubMed  Google Scholar 

  15. Dumoulin CL, Buonocore MH, Opsahl LR (1994) Noninvasive measurement of renal hemodynamic functions using gadolinium enhanced magnetic resonance imaging. Magn Reson Med 32:370–378. doi:10.1002/mrm.1910320312

    Article  PubMed  CAS  Google Scholar 

  16. Engine G, Esen T, Rozanes I (2000) MR urography findings of a duplicated ectopic ureter in an adult man. Eur Radiol 10:1253–1256. doi:10.1007/s003300000319

    Article  Google Scholar 

  17. Fradin JM, Regan F, Rodriquez R, Moore R (1999) Hydronephrosis in pregnancy: simultaneous depiction of fetal and maternal hydronephrosis by magnetic resonance urography. Urology 53:825–827. doi:10.1016/S0090-4295(98)00411-7

    Article  PubMed  CAS  Google Scholar 

  18. Grobner T (2006) Gadolinium—a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis? Nephrol Dial Transplant 21:1104–1108. doi:10.1093/ndt/gfk062

    Article  PubMed  CAS  Google Scholar 

  19. High WA, Ayers RA, Cowper SE (2007) Gadolinium is quantifiable within the tissue of patients with nephrogenic systemic fibrosis. J Am Acad Dermatol 56:710–712. doi:10.1016/j.jaad.2007.01.022

    Article  PubMed  Google Scholar 

  20. Hormann M, Brugger PC, Balassy C, Witzani L, Prayer D (2006) Fetal MRI of the urinary system. Eur J Radiol 57:303–311. doi:10.1016/j.ejrad.2005.11.028

    Article  PubMed  Google Scholar 

  21. Hwang SI, Kim SH, Kim YJ, Kim AY, Cho JY, Lee JW et al (2000) Effectiveness of MR urography in the evaluation of kidney which failed to opacify during excretory urography: comparison with ultrasonography. Korean J Radiol 1:152–158

    Article  PubMed  CAS  Google Scholar 

  22. Journel H, Guyot C, Barc RM, Belbeoch P, Quemener A, Jouan H (1989) Unexpected ultrasonographic prenatal diagnosis of autosomal dominant polycystic kidney disease. Prenat Diagn 9:663–671. doi:10.1002/pd.1970090910

    Article  PubMed  CAS  Google Scholar 

  23. Jung P, Brauers A, Nolte-Ernsting CA, Jakse G, Gunther RW (2000) Magnetic resonance urography enhanced by gadolinium and diuretics: a comparison with conventional urography in diagnosing the cause of ureteric obstruction. BJU Int 86:960–965. doi:10.1046/j.1464-410x.2000.00973.x

    Article  PubMed  CAS  Google Scholar 

  24. Katzberg RW, Buonocore MH, Ivanovic M, Pellot-Barakat C, Ryan JM, Whang K (2001) Functional, dynamic, and anatomic MR urography: feasibility and preliminary findings. Acad Radiol 8:1083–1099. doi:10.1016/S1076-6332(03)80720-1

    Article  PubMed  CAS  Google Scholar 

  25. Keengwe IN, Hegde S, Dearlove O (1999) Structured sedation programme for magnetic resonance imaging examination in children. Anaesthesia 54:1069–1072. doi:10.1046/j.1365-2044.1999.01106.x

    Article  PubMed  CAS  Google Scholar 

  26. Khanna PC, Karnik ND, Jankharia BG, Merchant SA, Joshi AR, Kukreja KU (2005) Magnetic resonance urography (MRU) versus intravenous urography (IVU) in obstructive uropathy: a prospective study of 30 cases. J Assoc Physicians India 53:527–534

    PubMed  CAS  Google Scholar 

  27. Khurana A, Runge VM, Narayanan M (2007) Nephrogenic systemic fibrosis: a review of 6 cases temporally related to gadodiamide injection (omniscan). Invest Radiol 42:139–145. doi:10.1097/01.rli.0000253505.88945.d5

    Article  PubMed  Google Scholar 

  28. Klein LT, Frager D, Subramanium A, Lowe FC (1998) Use of magnetic resonance urography. Urology 52:602–608. doi:10.1016/S0090-4295(98)00218-0

    Article  PubMed  CAS  Google Scholar 

  29. Leppert A, Nadalin S, Schirg E, Petersen C, Kardorff R, Galanski M et al (2002) Impact of magnetic resonance urography on preoperative diagnostic workup in children affected by hydronephrosis: should IVU be replaced? J Pediatr Surg 37:1441–1445. doi:10.1053/jpsu.2002.35408

    Article  PubMed  CAS  Google Scholar 

  30. Lin TF, Yeh YC, Yen YH (2005) Antiemetic and analgesic-sparing effects of diphenhydramine added to morphine intravenous patient-controlled analgesia. Br J Anaesth 94:835–839. doi:10.1093/bja/aei137

    Article  PubMed  CAS  Google Scholar 

  31. Maher MM, Prasad TA, Fitzpatrick JM, Corr J, Williams DH, Ennis JT et al (2000) Spinal dysraphism at MR urography: initial experience. Radiology 216:237–241

    PubMed  CAS  Google Scholar 

  32. Martin DR (2008) Nephrogenic systemic fibrosis. Pediatr Radiol 38:S125–S129. doi:10.1007/s00247-007-0589-8

    Article  PubMed  Google Scholar 

  33. Mason KP, Zurakowski D, Karian VE (2001) Sedatives used in pediatric imaging: comparison of IV pentobarbital with IV pentobarbital with midazolam added. AJR Am J Roentgenol 177:427–430

    PubMed  CAS  Google Scholar 

  34. Nolte-Ernsting CC, Adam GB, Gunther RW (2001) MR urography: examination techniques and clinical applications. Eur Radiol 11:355–372. doi:10.1007/s003300000685

    Article  PubMed  CAS  Google Scholar 

  35. Nolte-Ernsting CC, Staatz G, Tacke J, Gunther RW (2003) MR urography today. Abdom Imaging 28:191–209. doi:10.1007/s00261-001-0187-4

    Article  PubMed  CAS  Google Scholar 

  36. O’Malley M, Soto J, Yucel EK, Hussain H (1997) MR urography: evaluation of a three-dimensional fast spin-echo technique in patients with hydronephrosis. AJR 168:387–392

    PubMed  CAS  Google Scholar 

  37. Regan F, Bohlman ME, Khazan R, Rodriguez R, Schultze-Haakh H (1996) MR urography using HASTE imaging in the assessment of ureteric obstruction. Am J Roentgenol AJR 167:1115–1120

    CAS  Google Scholar 

  38. Rohrschneider WK, Haufe S, Wiesel M, Tonshoff B, Wunsch R, Darge K et al (2002) Functional and morphologic evaluation of congenital urinary combined static-dynamic MR urography: findings in kidneys with a single collecting system. Radiology 224:683–694. doi:10.1148/radiol.2243011207

    Article  PubMed  Google Scholar 

  39. Shipstone DP, Thomas DG, Darwent G, Morcos SK (2002) Magnetic resonance urography in patients with neurogenic bladder dysfunction and spinal dysraphism. BJU Int 89:658–664. doi:10.1046/j.1464-410X.2002.02632.x

    Article  PubMed  CAS  Google Scholar 

  40. Spencer JA, Tomlinson AJ, Weston MJ, Lloyd SN (2000) Early report: comparison of breath-hold MR excretory urography, Doppler ultrasound and isotope renography in evaluation of symptomatic hydronephrosis in pregnancy. Clin Radiol 55:446–453. doi:10.1053/crad.2000.0443

    Article  PubMed  CAS  Google Scholar 

  41. Tay CLM, Tan GM, Ng SBA (2001) Critical incidents in paediatric anaesthesia: an audit of 10,000 anaesthetics in Singapore. Paediatr Anaesth 11:711–718. doi:10.1046/j.1460-9592.2001.00767.x

    Article  PubMed  CAS  Google Scholar 

  42. Tomatir E, Atalay H, Gurses E (2004) Effects of low dose ketamine before induction on propofol anesthesia for pediatric magnetic resonance imaging. Paediatr Anaesth 14:845–850. doi:10.1111/j.1460-9592.2004.01303.x

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Urology Research Center, Department of Urology, Children’s Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Seyedmehdi Payabvash, Abdol-Mohammad Kajbafzadeh, Parisa Saeedi, Zhina Sadeghi & Azadeh Elmi

  2. Department of Radiology, Children’s Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Mehrzad Mehdizadeh

Authors
  1. Seyedmehdi Payabvash
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Abdol-Mohammad Kajbafzadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Parisa Saeedi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhina Sadeghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Azadeh Elmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mehrzad Mehdizadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Abdol-Mohammad Kajbafzadeh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Payabvash, S., Kajbafzadeh, AM., Saeedi, P. et al. Application of magnetic resonance urography in diagnosis of congenital urogenital anomalies in children. Pediatr Surg Int 24, 979–986 (2008). https://doi.org/10.1007/s00383-008-2196-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-008-2196-7

Keywords

Search

Navigation