Tsubota Masako, Takahara Taro, Nitatori Toshiaki, Hachiya Junichi
Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, JAPAN.
Radiat Med. 2004 Jul-Aug;22(4):212-7.
MR urography using heavily T2-weighted images can depict the urinary tract without the need for contrast medium. However, this technique has potential problems with regard to evaluating the non-dilated ureter. We compared the efficacy of cine MR urography (C-MRU) with static MR urography (S-MRU).
Twenty-two patients with suspected upper urinary tract disease underwent C-MRU. The final clinical diagnosis was compared with the diagnosis made using S-MRU and C-MRU, respectively. The sequence used was single-shot fast spin echo with a slice thickness of 50 mm, FOV of 45 cm, and 256x256 matrix. MR urography was obtained sequentially by 6 to 10 repetitions of single-shot scans with intermittent breath holding. S-MRU was used in the initial phase of this sequence, while C-MRU was used for the entire sequence. A final diagnosis was made based on 1) existence of stenosis, 2) rate of certainty of existence of stenosis, 3) etiology of stenosis.
No statistically significant difference was observed between S-MRU and C-MRU, except in certainty of existence of stenosis, where C-MRU (average rate: 2.82 +/- 0.39) was significantly superior to S-MRU (2.41 +/- 0.73).
C-MRU can improve the certainty of existence of urinary stenosis, and may be useful in excluding suspected stenoses in normal or undilated ureters.
使用重T2加权图像的磁共振尿路造影(MRU)无需使用造影剂即可描绘尿路。然而,该技术在评估未扩张的输尿管方面存在潜在问题。我们比较了电影磁共振尿路造影(C-MRU)和静态磁共振尿路造影(S-MRU)的效果。
22例疑似上尿路疾病的患者接受了C-MRU检查。将最终临床诊断分别与使用S-MRU和C-MRU做出的诊断进行比较。所使用的序列为单次激发快速自旋回波,层厚50mm,视野45cm,矩阵256×256。通过单次扫描6至10次重复并间歇性屏气依次获得MRU图像。在该序列的初始阶段使用S-MRU,而整个序列使用C-MRU。根据以下几点做出最终诊断:1)狭窄的存在;2)狭窄存在的确定率;3)狭窄的病因。
除了在狭窄存在的确定性方面,S-MRU和C-MRU之间未观察到统计学上的显著差异,其中C-MRU(平均率:2.82±0.39)明显优于S-MRU(2.41±0.73)。
C-MRU可以提高尿路狭窄存在的确定性,并且可能有助于排除正常或未扩张输尿管中疑似的狭窄。