The comparison of magnetic resonance urography with the combination of diuretic renal scintigraphy and urinary ultrasound in the diagnosis and follow up of ureteropelvic junction obstruction

Yıl 2015, Cilt: 2 Sayı: 3, 221 - 224, 01.03.2015

Murat Ciloglu , Mehmet Bilgehan Yuksel , Berk Burgu Omer Suat Fitoz Yakup Tarkan Soygur

https://doi.org/10.17546/msd.73402

Öz

The comparison of magnetic resonance urography with the combination of diuretic renal scintigraphy and urinary ultrasound in the diagnosis and follow up of ureteropelvic junction obstruction

Öz

Objectives:To evaluate the efficiency and reliability of MRU in diagnosis and follow up of children with UPJO.

Methods:Thedata of64 patients with the diagnosis of primary UPJO were analysed. All patients underwent Anderson-Hynes pyeloplasty and pelvic reduction. Pre- and postoperative results of renal pelvis AP diameter (RPAPD), separated renal function, renal transit time (RTT), and anatomical findings in USG and renal scintigraphywere compared with MRU findings to evaluate the possible differences and analyze the efficiency and reliability of MRU in the management of UPJO.

Results:The mean age 7.2 ± 1.8 years. All patients had unilateral hydronephrosis including 16 grade 2, 24 grade 3 and 24 grade 4. Pre- and postoperative RPAPDs in two techniques were also similar (P = 0.084, P = 0.576). Separated renal functions were evaluated by MRU with similar affectivity and sensitivity in DRS (P = 0.867). The comparison of mean pre and postoperative RTT results showed a significant improvement in mean postoperative RTT value (P = 0.024).

Conclusions:MRU has the potential to become the imaging study of choice in the diagnosis and follow up of obstructive uropathy, and it may have a more significant role in the management of UPJO in the near future.

Keywords: MR urography, ultrasonography, renal scintigraphy, UPJ obstruction, pyeloplasty, children.

Anahtar Kelimeler

Memantine, propofol, erythrocyte deformability

Kaynakça

• Peters CA. (1995). Urinary tract obstruction in children. J Urol;154: 1874- 84.
• Takeda M, Katayama Y, Tsutsui T, Takahashi H, Komeyama T, Mizusawa T, et al. (1994). Value of dimercaptosuccinic acid single photon emission computed tomography and magnetic resonance imaging in detecting renal injury in pediatric patients with vesicoureteral reflux. Comparison with dimercaptosuccinic acid planar scintigraphy and intravenous pyelography. EurUrol ;25(4): 320- 25.
• Rodriguez LV, Spielman D, Herfkens FJ, Shortliffe LD. (2001). Magnetic resonance imaging for the evaluation of hydronephrosis, reflux and renal scarring in children. J Urol ;166(3): 1023- 27.
• -
• Perez-Brayfield MR, Kirsch AJ, Jones RA, Grattan-Smith JD. (2003). A prospective study comparing ultrasound, nuclear scintigraphy and dynamic contrast enhanced magnetic resonance imaging in the evaluation of hydronephrosis. J Urol ;170(4 Pt1): 1330- 34.
• Grattan-Smith JD, Perez-Brayfield MR, Jones RA, Little S, Smith EA, Scherz HC, et al. (2003) MR imaging of kidneys: functional evaluation using F-15 perfusion imaging. PediatrRadiol ;33(5): 293- 304.
• -
• Jones RA, Perez-Brayfield MR, Kirsch AJ, Grattan-Smith JD. (2004). Renal transit time with MR urography in children. Radiology ;233(1): 41- 50.
• Hackstein N, Heckrodt J, Rau WS. (2003). Measurement of single-kidney glomerular filtration rate using a contrast-enhanced dynamic gradient-echo sequence and the Rutland Patlak plot technique. J MagnResonImag ;18(6): 714- 25.
• Han SW, Lee SE, Kim JH, Jeong HJ, Rha KH, Choi SK. (1998). Does delayed operation for pediatricureteropelvic junction obstruction cause histopatological changes? J Urol ; 160(3 Pt 2): 984-988.
• McDaniel BB, Jones RA, Scherz H. Kirsch AJ, Little SB, Grattan-Smith JD. (2005). Dynamic, contrastenhanced, MR urography in the evaluation of pediatrichydronephrosis: part 2, anatomic and functional assessment of UPJ obstruction. AJR Am J Roentgenol ; 185(6): 1598- 1608.
• Van Cangh PJ, Wilmart JF, Opsomer RJ. (1994). Long-term results and late recurrence after endoureteropyelotomy: a critical analysis of prognostic factors. J Urol ; 151(4): 934- 37.
• Sampaio FJ. (1998). Vascular anatomy at the ureteropelvic junction. UrolClin North Am ; 25(2):251- 8.
• Chu WC, Lam WW, Chan KW, Yeung CK, Lee KH, Silhoe JD. (2004). Dynamic gadolinium-enhanced magnetic resonance for assessing drainage in dilated pelvicalyceal systems with moderate renal function: preliminary results and comparison with diuresis renography. BJU Int ; 93(6): 830- 4.