Kocaoglu Murat, Bulakbasi Nail, Ilica Ahmet Turan, Gok Faysal, Tayfun Cem, Somuncu Ibrahim
Department of Radiology, Gulhane Military Medical School, Ankara, Turkey.
J Magn Reson Imaging. 2006 Aug;24(2):349-55. doi: 10.1002/jmri.20637.
To evaluate the time-signal intensity (SI) curves generated from intravenous (IV) gadodiamide-enhanced dynamic magnetic resonance (MR) urographic scans for identifying vesicoureteral reflux (VUR) during bladder filling.
MR urographic studies of children were retrospectively reviewed, and 52 ureterorenal units of 26 patients (15 females and 11 males, mean age = 5.5 years) who had also undergone voiding cystourethrographic (VCUG) examination were included in this study. The patients were examined on a 1.5T scanner. For functional MR urography and to generate time-SI curves, we used a post IV contrast-enhanced two-dimensional (2D) fast field echo (FFE) sequence (TR = 17 msec, TE = 3.2 msec, flip angle (FA) = 90 degrees ) in the coronal plane. MR urographic time-SI curves that demonstrated a prompt and concave fall of the initial third phase followed by intermittent or constantly increasing SI peaks above the baseline from which the second phase starts were considered to have VUR. We compared the differences in time-SI curves between the control group and patients with VUR during bladder filling.
Twelve ureterorenal units of eight patients (four bilateral and four unilateral) had VUR during bladder filling on VCUG. The time-SI curves of these patients showed intermittent (N = 8 ureterorenal units), and constantly increasing (N = 4 ureterorenal units) SI peaks consistent with VUR. One patient also had bilateral abnormal time-SI curves suggesting VUR despite the normal VCUG study. In the control group, 25 units had normal triphase time-SI curves, six renal units had urinary dilatation with good washout after diuretic injection, and four renal units had upper urinary dilatation without contrast washout, while five renal units did not show any function. None of the patients in the control group revealed distortion in the time-SI curve. The differences in time-SI curves patterns between the control group and patients with VUR during bladder filling were statistically significant (P < 0.001).
After a prompt and concave decrease of the initial third phase of the time-SI curve, intermittent spikes or a constant rise in SI above the baseline suggest the existence of VUR.
评估静脉注射钆双胺增强动态磁共振（MR）尿路造影扫描生成的时间-信号强度（SI）曲线，以识别膀胱充盈期间的膀胱输尿管反流（VUR）。
回顾性分析儿童MR尿路造影研究，本研究纳入了26例患者（15例女性和11例男性，平均年龄 = 5.5岁）的52个输尿管肾单位，这些患者同时也接受了排尿性膀胱尿道造影（VCUG）检查。患者在1.5T扫描仪上进行检查。对于功能性MR尿路造影并生成时间-SI曲线，我们在冠状面使用静脉注射造影剂增强后的二维（2D）快速场回波（FFE）序列（TR = 17毫秒，TE = 3.2毫秒，翻转角（FA） = 90度）。MR尿路造影时间-SI曲线若显示初始第三阶段迅速且呈凹形下降，随后在第二阶段开始的基线之上出现间歇性或持续升高的SI峰值，则被认为存在VUR。我们比较了对照组与膀胱充盈期间VUR患者时间-SI曲线的差异。
8例患者（4例双侧和4例单侧）的12个输尿管肾单位在VCUG检查中膀胱充盈时存在VUR。这些患者的时间-SI曲线显示出与VUR一致的间歇性（n = 8个输尿管肾单位）和持续升高（n = 4个输尿管肾单位）的SI峰值。1例患者尽管VCUG检查正常，但双侧时间-SI曲线异常提示存在VUR。在对照组中，25个单位具有正常的三相时间-SI曲线，6个肾单位在注射利尿剂后有尿液扩张且冲洗良好，4个肾单位有上尿路扩张但无造影剂冲洗，而5个肾单位未显示任何功能。对照组中没有患者的时间-SI曲线出现扭曲。对照组与膀胱充盈期间VUR患者时间-SI曲线模式的差异具有统计学意义（P < 0.001）。
在时间-SI曲线的初始第三阶段迅速且呈凹形下降后，间歇性峰值或SI在基线之上持续上升提示存在VUR。
