Takazakura Ryutaro, Johnin Kazuyoshi, Furukawa Akira, Nitta Norihisa, Takahashi Masashi, Okada Yusaku, Murata Kiyoshi
Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan.
J Magn Reson Imaging. 2007 Jan;25(1):170-4. doi: 10.1002/jmri.20822.
To assess the feasibility of magnetic resonance voiding cystourethrography (MRVCUG) using MR fluoroscopy for evaluation of vesicoureteral reflux (VUR), and its use as a noninvasive alternative to standard VCUG.
A total of 22 MR studies of 16 patients (five months to 41 years old) with primary VUR diagnosed by standard VCUG were evaluated. Six patients underwent MR studies and standard VCUG pre- and postoperatively. MR fluoroscopy was executed with a non-enhanced heavily T2-weighted single-shot fast spin-echo (FSE) sequence. The MR findings were correlated with those obtained by the gold standard, standard VCUG.
Of the 44 kidney-ureter units, 20 were refluxing on MRVCUG and 21 were refluxing on standard VCUG. There were one false-positive and two false-negative units. MRVCUG was 90% sensitive with a specificity of 96% for detecting VURs that were calculated based on kidney-ureter units. Two false-negative units were found in mild cases (grade I and II). For the units of grade III, IV, and V (high-grade reflux), MRVCUG detected all of the refluxing renal collecting systems.
MRVCUG can demonstrate high-grade reflux without ionizing radiation or catheterization.
评估利用磁共振荧光透视法进行磁共振排尿性膀胱尿道造影（MRVCUG）以评估膀胱输尿管反流（VUR）的可行性，以及其作为标准排尿性膀胱尿道造影（VCUG）的非侵入性替代方法的应用。
对16例经标准VCUG诊断为原发性VUR的患者（年龄5个月至41岁）的22项磁共振研究进行评估。6例患者在术前和术后接受了磁共振研究及标准VCUG检查。采用非增强的重T2加权单次激发快速自旋回波（FSE）序列进行磁共振荧光透视检查。将磁共振检查结果与金标准——标准VCUG的结果进行对比。
在44个肾输尿管单元中，20个在MRVCUG上显示有反流，21个在标准VCUG上显示有反流。有1个假阳性单元和2个假阴性单元。基于肾输尿管单元计算，MRVCUG检测VUR的敏感性为90%，特异性为96%。在轻度病例（I级和II级）中发现了2个假阴性单元。对于III级、IV级和V级（重度反流）的单元，MRVCUG检测到了所有有反流的肾集合系统。
MRVCUG无需电离辐射或插管即可显示重度反流。
