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Contrast-enhanced dynamic MR nephrography using the TurboFLASH navigator-gating technique in children

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Abstract

The purpose of this work was to test the feasibility of an MR examination protocol for the comprehensive assessment of renal morphology, excretion and split renal function using a navigator-gated TurboFLASH sequence. A navigator-gated T1-weighted single-slice TurboFLASH sequence suitable for dynamic MR urography and nephrography was implemented. A protocol was developed allowing for assessment of urinary excretion and split renal function by recording the renal clearance of a gadolinium (Gd) diethylene-triamine-pentacetic-acid (DTPA) bolus. Ten patients aged between 14 months and 14 years (mean age 4.8±4.6 years) were evaluated with the following indications: pelvicalyceal dilatation (n=4), follow-up after pyeloplasty (n=1), duplex systems (n=3), large renal cyst (n=1), and renal insufficiency (n=1). Dynamic MR urography and MR split renal function were compared to MAG3 scintigraphy. Evaluation of morphology, excretion and function required 50–60 minutes examination time, plus 10 minutes for post-processing. The TurboFLASH sequence yielded image acquisition at nearly identical diaphragm positions allowing for accurate region-of-interest evaluation within the renal parenchyma and the urinary passage. Static and dynamic MR urography showed the morphology of the urinary tract and excretion with sufficient diagnostic imaging quality, and the results were in diagnostic compliance with scintigraphy. MRI and scintigraphy yielded similar results for split renal function with a correlation coefficient of R=0.968 determined by linear regression. Our conclusions were that the method is robust, easy to perform on a clinical 1.5 T MRI system, rapid to evaluate and post-process and, therefore, easy to incorporate into clinical routine. Compared to scintigraphy, the higher spatial resolution of the MR examination provides additional important information improving the management of the pediatric patients without the application of radioactive tracers.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Section of Experimental Radiology, Eberhard-Karls University, Hoppe Seyler Strasse 3, 72076, Tübingen, Germany

    Andreas Boss, Petros Martirosian & Fritz Schick

  2. Department of Diagnostic Radiology, Eberhard-Karls University, Tübingen, Germany

    Andreas Boss, Juergen F. Schaefer, Claus D. Claussen, Klaus Küper & Heinz-Peter Schlemmer

  3. Department of Pediatric Surgery, Eberhard-Karls University, Tübingen, Germany

    Hans-Walter Hacker

  4. Department of Pediatric Radiology, Julius-Maximilians University, Würzburg, Germany

    Kassa Darge

Authors
  1. Andreas Boss
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  2. Juergen F. Schaefer
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  3. Petros Martirosian
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  4. Hans-Walter Hacker
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  5. Kassa Darge
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  6. Claus D. Claussen
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  7. Klaus Küper
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  8. Fritz Schick
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  9. Heinz-Peter Schlemmer
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Correspondence to Andreas Boss.

Additional information

Andreas Boss and Juergen F. Schaefer contributed equally to this work.

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Boss, A., Schaefer, J.F., Martirosian, P. et al. Contrast-enhanced dynamic MR nephrography using the TurboFLASH navigator-gating technique in children. Eur Radiol 16, 1509–1518 (2006). https://doi.org/10.1007/s00330-006-0182-9

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  • DOI: https://doi.org/10.1007/s00330-006-0182-9

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