Payabvash Seyedmehdi, Kajbafzadeh Abdol-Mohammad, Saeedi Parisa, Sadeghi Zhina, Elmi Azadeh, Mehdizadeh Mehrzad
Pediatric Urology Research Center, Department of Urology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Pediatr Surg Int. 2008 Sep;24(9):979-86. doi: 10.1007/s00383-008-2196-7. Epub 2008 Jul 31.
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.
磁共振尿路造影（MRU）已成为评估泌尿生殖系统异常的一种有用辅助手段。在本研究中，当传统成像方式的结果不明确时，我们评估了MRU诊断不同先天性泌尿生殖系统异常的能力。本系列共纳入90名儿童。对这些儿童进行了T2加权和对比增强T1加权MRU序列检查。将结果与超声、静脉肾盂造影、肾核素扫描和排尿性膀胱尿道造影的结果进行比较。之所以对这些儿童进行MRU检查，是因为传统成像方式不明确或怀疑存在并存的泌尿生殖系统异常。本研究仅纳入了那些接受手术的病例，并将手术结果作为统计评估的参考标准。回顾了61名男孩（平均年龄2.3岁，范围2个月至12岁）和29名女孩（平均年龄3.3岁，范围3个月至12岁）的记录。最终诊断为输尿管肾盂连接部梗阻（n = 25）、膀胱输尿管连接部梗阻（n = 16）、输尿管囊肿（n = 19）、异位肾（n = 11）、后尿道瓣膜（n = 17）和多囊肾（n = 2）。MRU、静脉肾盂造影、肾核素扫描、超声和排尿性膀胱尿道造影对上述异常诊断的总体敏感性分别为86%、63%、50%、44%和41%。在诊断输尿管末端扩张（100%）和输尿管囊肿（89%）方面，MRU比其他成像方式敏感得多。MRU为儿童尿路先天性异常的成像提供了一种可靠的非侵入性技术，T2加权MRU序列可提供尿路未增强的静态水成像以及描绘相邻软组织病变，T1加权MRU技术可模拟传统静脉肾盂造影。两种MRU序列可联合用于尿路的全面检查。
