Araştırma Makalesi
BibTex RIS Kaynak Göster

Çocukluk Dönemi Obstrüktif Böbrek Hastalıklarında Dinamik Manyetik Rezonans Ürografinin Tanı Değeri

Yıl 2017, Cilt: 7 Sayı: 4, 306 - 315, 08.12.2017
https://doi.org/10.16899/gopctd.343178

Öz

Amaç: Bu çalışmanın amacı, pediatrik üriner sistem hastalıklarının tanısında dinamik manyetik rezonans ürografi (MRÜ)’nin fonksiyonel olarak tanı değerini araştırmak ve obstrüktif patolojilerde obstrüksiyonun derecesinin belirlenmesinde dinamik MRÜ’nin doğruluğunu ortaya koymaktır.  

Materyal ve Metod: Çalışmaya diüretik renal sintigrafi (DRS)’den önce veya sonra dinamik MRÜ ile değerlendirilen toplam 33 hasta dahil edildi. Hastaların yaşları 1 ay ile 18 yıl (ortalama yaş=7.03 yıl) arasında değişmekteydi. Obstrüksiyonun tanısında standart test olarak DRS kabul edilerek, dinamik MRÜ’nin  sensitivite, spesifite, pozitif prediktif değeri ve negatif prediktif değeri hesaplandı.

Bulgular: Dinamik MRÜ ve DRS sonuçları arasında fonksiyonel olarak farklılık bulunup bulunmadığını araştırmak için bağımlı gruplarda t testi yapıldı. Split renal fonksiyon açısından dinamik MRÜ ve DRS sonuçları arasında istatistiksel olarak anlamlı farklılık saptanmadı (p=0.978). 

Sonuç: Çalışmamızda dinamik MRÜ ve DRS sonuçları arasında renal fonksiyonların değerlendirilmesi bakımından çok güçlü ve yüksek bir tutarlılık ve uyum saptadık. Dinamik MRÜ’nin eksresyon açısından normal ve anormal böbrekleri ayırtetmedeki etkinliğini %100 olarak saptadık.


Kaynakça

  • 1. Dickerson EC, Dillman JR, Smith EA, Di Pietro MA, Lebowitz RL, Darge K. Pediatric MR Urography: Indications, Techniques and Approach to Review. Radiographics 2015;35(4):1208-30.
  • 2. Levendecker JR, Barnes CE, Zagoria RJ. MR urography: techniques and clinical applications. Radiographics 2008;28:23–46.
  • 3. Battal B, Kocaoglu M, Akgun V, Aydur E, Dayanc M, Ilica T. Feasibility of MR urography in patients with urinary diversion. J Med Imaging Radiat Oncol 2011;55:542–50.
  • 4. Kocyiğit A, Yuksel S, Bayram R, Yılmaz İ, Karabulut N. Efficacy of magnetic resonance urography in detecting renal scars in children with vesicoureteral reflux. Pediatr Nephrol 2014;29:1215–20.
  • 5. Grattan-Smith JD, Little SB, Jones RA MR urography evaluation of obstructive uropathy. Pediatr Radiol 2008;38:49–69.
  • 6. Grattan-Smith JD, Jones RA. MR urography: technique and results for the evaluation of urinary obstruction in pediatric population. Magn Reson Imaging Clin N Am 2008;16:643–60.
  • 7. Darge K, Anupindi SA, Jaramillo D. MR imaging of the abdomen and pelvis in infants, children, and adolescents. Radiology 2011;261:12–29.
  • 8. Bayrak IK, Ozmen Z, Nural MS, Danaci M. Korean J Radiol 2008 Jun;9(3):250-7.
  • 9. Avni F, Bali MA, Regnault M, et al. MR urography in children. Eur J Radiol 2002;43:154-66.
  • 10. Kocaoglu M, Bulakbasi N, Ilica AT, Gok F, Tayfun C, Somuncu I. Intravenous contrast-enhanced dynamic MR urography:diagno¬sis of vesicoureteral reflux during bladder filling with time-signal intensity curves. J Magn Reson Imaging 2006;24:349-55.
  • 11.Brown SCW. Nuclear medicine in the clinical diagnosis and treatment of obstructive uropathy. In: Murray ICP, Ells PJ, eds. Edinburgh, Scotland: Churchill Livingstone, 1998; 291-313.
  • 12.Rohrschneider WK, Becker K, Hoffend J, et al. Combined static-dynamic MR urography for the simultaneous evaluation of morphology and function in urinary tract obstruction. II. Findings in experimentally induced ureteric stenosis. Pediatr Radiol 2000;30:523-32.
  • 13. Khrichenko D, Darge K. Functional analysis in MR urography—made simple. Pediatr Radiol 2010;40(2):182–199.
  • 14. Little SB, Jones RA, Grattan-Smith JD. Evaluation of UPJ obstruction before and after pyeloplasty using MR urography. Pediatr Radiol 2008;38:106–124.
  • 15. Teh HS, Ang ES, Weng WC, et al. MR renogra¬phy using a dynamic gradient-echo sequence and low-dose gadopentetate dimeglumine as alternative to radionuclide renography. AJR 2003;181:441-450.
  • 16. Vivier PH, Blondiaux E, Dolores M, Marouteau-Pasquier N, Brasseur M, Petitjean C, Dacher . J Radiol 2009 Jan;90:11-9.
  • 17. Khrichenko D, Darge K. Functional analysis in MR urography-made simple. Pediatr Radiol 2010;40(2):182–99.
  • 18. Mazdak H, Karam M, Ghassami F, Malekpour A. Agreement between static magnetic resonance urography and diuretic renal scintigraphy in patients with ureteropelvic junction obstruction after pyeloplasty. Adv Biomed Res 2015;4:186.
  • 19. Rohrschneider WK, Haufe S, Wiesel M, et al. Functional and morphologic evaluation of congenital urinary tract dilatation by using combined static-dynamic MR urography: findings in kidneys with a single collecting system. Radiology 2002;224:683–94.
  • 20. Grattan-Smith JD, Perez-Bayfield MR, Jones RA, et al. MR imaging of kidneys: functional evaluation using F-15 perfusion imaging. Pediatr Ra¬diol 2003;33:293-304.
  • 21. Perez-Brayfield MR, Kirsch AJ, Jones RA, Grattan¬ Smith JD. A prospective study comparing ultra¬sound, nuclear scintigraphy and dynamic contrast en¬hanced magnetic resonance imaging in the evalua¬tion of hydronephrosis. J Urol 2003;170:1330-4.
  • 22. Jones RA, Perez-Brayfield M, Kirsch AJ, Grattan-Smith JD. Renal transit time using MR urography: a new classification of obstructive uropathy in children. Radiology 2004;233:41-50.
  • 23. Battal B, Kocaoğlu M, Akgün V, İnce S, Gök F, Taşar M. Split-bolus MR urography: synchronous visualization of obstructing bolus MR urography: synchronous vessels and collecting system in children. Diagn Interv Radiol. 2015 Nov-Dec;21(6):498-502.
  • 24. Rohrschneider WK, Hoffend J, Becker K, et al. Combined static-dynamic MR urography for the simultaneous evaluation of morphology and function in urinary tract obstruction. I. Evaluation of the normal status in an animal model. Pediatr Radiol 2000;30:511-22.
  • 25. Jones RA, Easley K, Little SB, et al. Dynamic contrast-enhanced MR urography in the evaIuation of pediatric hydronephrosis:Part 1, functional assessment. Am J Roentgenol 2005; 185:1598-607.
  • 26. Nardone B, Saddleton E, Laumann AE, et al. Pediatric nephrogenic systemic fibrosis is rarely reported: a RADAR report. Pediatr Radiol 2014;44(2):173–180.
  • 27. Weinreb JC. Impact on hospital policy: Yale experience. J Am Coll Radiol 2008;5(1):53–6.
  • 28. Altun E, Martin DR, Wertman R, Lugo-Somolinos A, Fuller ER, Semelka RC. Nephrogenic systemic fibrosis: change in incidence following a switch in gadolinium agents and adoption of a gadolinium policy-report from two U.S. universities. Radiology 2009;253(3):689–96.
  • 29. Martin DR. Nephrogenic systemic fibrosis. Pediatr Radiol 2008;38:125–9.
  • 30. Schwartz GJ, Muñoz A, Schneider MF, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009;20(3):629–37.

Diagnostic Value Of Dynamic Magnetic Resonance Urography In Childhood Obstructive Kidney Diseases

Yıl 2017, Cilt: 7 Sayı: 4, 306 - 315, 08.12.2017
https://doi.org/10.16899/gopctd.343178

Öz

Purpose: The aim of this study was
to investigate the functional value of dynamic magnetic resonance urography
(MRU) for the diagnosis of pediatric urinary system diseases,  to establish the accuracy of dynamic MRU in
determination of  obstructive
pathologies.

Materials and methods: A Total of
33 patients that were evaluated with diuretic renal scintigraphy (DRS) either
before or after dynamic MRU examination were included in the study. Their age
varied from 1 month to 18 years (mean age was 7.03 years).  Accepting DRS as the standard test for
diagnosis of obstruction, sensitivity, specificity, and positive predictive and
negative predictive values of dynamic MRU were calculated.

Results: In order to find whether there was a functional difference between
dynamic MRU and DRS measurement results, dependent t-test for paired samples
was used .There was no statistically significant difference between (p = 0.978)
in split renal function(SRF) results which calculated from dynamic MRU and DRS examinations.







Conclusions: We found a very strong
and highly significant correlation and consistency between dynamic MRU and DRS
methods in terms of evaluation of renal functions. Dynamic MRU is 100%
effective for discrimination of normal and abnormal kidneys in terms of
excretion.

Kaynakça

  • 1. Dickerson EC, Dillman JR, Smith EA, Di Pietro MA, Lebowitz RL, Darge K. Pediatric MR Urography: Indications, Techniques and Approach to Review. Radiographics 2015;35(4):1208-30.
  • 2. Levendecker JR, Barnes CE, Zagoria RJ. MR urography: techniques and clinical applications. Radiographics 2008;28:23–46.
  • 3. Battal B, Kocaoglu M, Akgun V, Aydur E, Dayanc M, Ilica T. Feasibility of MR urography in patients with urinary diversion. J Med Imaging Radiat Oncol 2011;55:542–50.
  • 4. Kocyiğit A, Yuksel S, Bayram R, Yılmaz İ, Karabulut N. Efficacy of magnetic resonance urography in detecting renal scars in children with vesicoureteral reflux. Pediatr Nephrol 2014;29:1215–20.
  • 5. Grattan-Smith JD, Little SB, Jones RA MR urography evaluation of obstructive uropathy. Pediatr Radiol 2008;38:49–69.
  • 6. Grattan-Smith JD, Jones RA. MR urography: technique and results for the evaluation of urinary obstruction in pediatric population. Magn Reson Imaging Clin N Am 2008;16:643–60.
  • 7. Darge K, Anupindi SA, Jaramillo D. MR imaging of the abdomen and pelvis in infants, children, and adolescents. Radiology 2011;261:12–29.
  • 8. Bayrak IK, Ozmen Z, Nural MS, Danaci M. Korean J Radiol 2008 Jun;9(3):250-7.
  • 9. Avni F, Bali MA, Regnault M, et al. MR urography in children. Eur J Radiol 2002;43:154-66.
  • 10. Kocaoglu M, Bulakbasi N, Ilica AT, Gok F, Tayfun C, Somuncu I. Intravenous contrast-enhanced dynamic MR urography:diagno¬sis of vesicoureteral reflux during bladder filling with time-signal intensity curves. J Magn Reson Imaging 2006;24:349-55.
  • 11.Brown SCW. Nuclear medicine in the clinical diagnosis and treatment of obstructive uropathy. In: Murray ICP, Ells PJ, eds. Edinburgh, Scotland: Churchill Livingstone, 1998; 291-313.
  • 12.Rohrschneider WK, Becker K, Hoffend J, et al. Combined static-dynamic MR urography for the simultaneous evaluation of morphology and function in urinary tract obstruction. II. Findings in experimentally induced ureteric stenosis. Pediatr Radiol 2000;30:523-32.
  • 13. Khrichenko D, Darge K. Functional analysis in MR urography—made simple. Pediatr Radiol 2010;40(2):182–199.
  • 14. Little SB, Jones RA, Grattan-Smith JD. Evaluation of UPJ obstruction before and after pyeloplasty using MR urography. Pediatr Radiol 2008;38:106–124.
  • 15. Teh HS, Ang ES, Weng WC, et al. MR renogra¬phy using a dynamic gradient-echo sequence and low-dose gadopentetate dimeglumine as alternative to radionuclide renography. AJR 2003;181:441-450.
  • 16. Vivier PH, Blondiaux E, Dolores M, Marouteau-Pasquier N, Brasseur M, Petitjean C, Dacher . J Radiol 2009 Jan;90:11-9.
  • 17. Khrichenko D, Darge K. Functional analysis in MR urography-made simple. Pediatr Radiol 2010;40(2):182–99.
  • 18. Mazdak H, Karam M, Ghassami F, Malekpour A. Agreement between static magnetic resonance urography and diuretic renal scintigraphy in patients with ureteropelvic junction obstruction after pyeloplasty. Adv Biomed Res 2015;4:186.
  • 19. Rohrschneider WK, Haufe S, Wiesel M, et al. Functional and morphologic evaluation of congenital urinary tract dilatation by using combined static-dynamic MR urography: findings in kidneys with a single collecting system. Radiology 2002;224:683–94.
  • 20. Grattan-Smith JD, Perez-Bayfield MR, Jones RA, et al. MR imaging of kidneys: functional evaluation using F-15 perfusion imaging. Pediatr Ra¬diol 2003;33:293-304.
  • 21. Perez-Brayfield MR, Kirsch AJ, Jones RA, Grattan¬ Smith JD. A prospective study comparing ultra¬sound, nuclear scintigraphy and dynamic contrast en¬hanced magnetic resonance imaging in the evalua¬tion of hydronephrosis. J Urol 2003;170:1330-4.
  • 22. Jones RA, Perez-Brayfield M, Kirsch AJ, Grattan-Smith JD. Renal transit time using MR urography: a new classification of obstructive uropathy in children. Radiology 2004;233:41-50.
  • 23. Battal B, Kocaoğlu M, Akgün V, İnce S, Gök F, Taşar M. Split-bolus MR urography: synchronous visualization of obstructing bolus MR urography: synchronous vessels and collecting system in children. Diagn Interv Radiol. 2015 Nov-Dec;21(6):498-502.
  • 24. Rohrschneider WK, Hoffend J, Becker K, et al. Combined static-dynamic MR urography for the simultaneous evaluation of morphology and function in urinary tract obstruction. I. Evaluation of the normal status in an animal model. Pediatr Radiol 2000;30:511-22.
  • 25. Jones RA, Easley K, Little SB, et al. Dynamic contrast-enhanced MR urography in the evaIuation of pediatric hydronephrosis:Part 1, functional assessment. Am J Roentgenol 2005; 185:1598-607.
  • 26. Nardone B, Saddleton E, Laumann AE, et al. Pediatric nephrogenic systemic fibrosis is rarely reported: a RADAR report. Pediatr Radiol 2014;44(2):173–180.
  • 27. Weinreb JC. Impact on hospital policy: Yale experience. J Am Coll Radiol 2008;5(1):53–6.
  • 28. Altun E, Martin DR, Wertman R, Lugo-Somolinos A, Fuller ER, Semelka RC. Nephrogenic systemic fibrosis: change in incidence following a switch in gadolinium agents and adoption of a gadolinium policy-report from two U.S. universities. Radiology 2009;253(3):689–96.
  • 29. Martin DR. Nephrogenic systemic fibrosis. Pediatr Radiol 2008;38:125–9.
  • 30. Schwartz GJ, Muñoz A, Schneider MF, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009;20(3):629–37.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Çalışma
Yazarlar

Zafer Özmen

Fatma Aktaş

İlkay Koray Bayrak Bu kişi benim

Serdar Savaş Gül

Türkay Yalın Bu kişi benim

Yayımlanma Tarihi 8 Aralık 2017
Kabul Tarihi 5 Aralık 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 7 Sayı: 4

Kaynak Göster

APA Özmen, Z., Aktaş, F., Bayrak, İ. K., Gül, S. S., vd. (2017). Çocukluk Dönemi Obstrüktif Böbrek Hastalıklarında Dinamik Manyetik Rezonans Ürografinin Tanı Değeri. Çağdaş Tıp Dergisi, 7(4), 306-315. https://doi.org/10.16899/gopctd.343178
AMA Özmen Z, Aktaş F, Bayrak İK, Gül SS, Yalın T. Çocukluk Dönemi Obstrüktif Böbrek Hastalıklarında Dinamik Manyetik Rezonans Ürografinin Tanı Değeri. J Contemp Med. Aralık 2017;7(4):306-315. doi:10.16899/gopctd.343178
Chicago Özmen, Zafer, Fatma Aktaş, İlkay Koray Bayrak, Serdar Savaş Gül, ve Türkay Yalın. “Çocukluk Dönemi Obstrüktif Böbrek Hastalıklarında Dinamik Manyetik Rezonans Ürografinin Tanı Değeri”. Çağdaş Tıp Dergisi 7, sy. 4 (Aralık 2017): 306-15. https://doi.org/10.16899/gopctd.343178.
EndNote Özmen Z, Aktaş F, Bayrak İK, Gül SS, Yalın T (01 Aralık 2017) Çocukluk Dönemi Obstrüktif Böbrek Hastalıklarında Dinamik Manyetik Rezonans Ürografinin Tanı Değeri. Çağdaş Tıp Dergisi 7 4 306–315.
IEEE Z. Özmen, F. Aktaş, İ. K. Bayrak, S. S. Gül, ve T. Yalın, “Çocukluk Dönemi Obstrüktif Böbrek Hastalıklarında Dinamik Manyetik Rezonans Ürografinin Tanı Değeri”, J Contemp Med, c. 7, sy. 4, ss. 306–315, 2017, doi: 10.16899/gopctd.343178.
ISNAD Özmen, Zafer vd. “Çocukluk Dönemi Obstrüktif Böbrek Hastalıklarında Dinamik Manyetik Rezonans Ürografinin Tanı Değeri”. Çağdaş Tıp Dergisi 7/4 (Aralık 2017), 306-315. https://doi.org/10.16899/gopctd.343178.
JAMA Özmen Z, Aktaş F, Bayrak İK, Gül SS, Yalın T. Çocukluk Dönemi Obstrüktif Böbrek Hastalıklarında Dinamik Manyetik Rezonans Ürografinin Tanı Değeri. J Contemp Med. 2017;7:306–315.
MLA Özmen, Zafer vd. “Çocukluk Dönemi Obstrüktif Böbrek Hastalıklarında Dinamik Manyetik Rezonans Ürografinin Tanı Değeri”. Çağdaş Tıp Dergisi, c. 7, sy. 4, 2017, ss. 306-15, doi:10.16899/gopctd.343178.
Vancouver Özmen Z, Aktaş F, Bayrak İK, Gül SS, Yalın T. Çocukluk Dönemi Obstrüktif Böbrek Hastalıklarında Dinamik Manyetik Rezonans Ürografinin Tanı Değeri. J Contemp Med. 2017;7(4):306-15.