Effectiveness of MR Urography in the Evaluation of Kidney which Failed to Opacify during Excretory Urography: Comparison with Ultrasonography

  • Sung-Il Hwang (Department of Radiology, Seoul National University Hospital) ;
  • Seung Hyup Kim (Department of Radiology, Seoul National University Hospital) ;
  • Young Jun Kim (Department of Radiology, Seoul National University Hospital) ;
  • Ah Young Kim (Department of Radiology, Seoul National University Hospital) ;
  • Jung Yun Cho (Department of Radiology, Seoul National University Hospital) ;
  • Joon Woo Lee (Department of Radiology, Seoul National University Hospital) ;
  • Hyung-Seok Kim (Department of Radiology, Jeju Medical Center) ;
  • Kyung Mo Yeon (Department of Radiology, Seoul National University Hospital)
  • 투고 : 2000.04.29
  • 심사 : 2000.07.18
  • 발행 : 2000.09.30

초록

Objective: The purpose of this study was to compare the effectiveness of MR urography (MRU) with that of ultrasonography (US) in the evaluation of urinary tract when this failed to opacify during excretory urography (EXU). Materials and Methods: Twelve urinary tracts in 11 patients were studied. In each case, during EXU, the urinary system failed to opacify within one hour of the injection of contrast media, and US revealed dilatation of the pelvocalyceal system. Patients underwent MRU, using a HASTE sequence with the breath-hold technique; multi-slice acquisition was then performed, and the images were reconstructed using maximal intensity projection. Each set of images was evaluated by three radiologists to determine the presence, level, and cause of urinary tract obstruction. Results: Obstruction was present in all twelve cases, and in all of these, MRU accurately demonstrated its level. In this respect, however, US was successful in only ten. The cause of obstruction was determined by MRU in eight cases, but by US in only six. In all of these six, MRU also successfully demonstrated the cause. Conclusion: MRU is an effective modality for evaluation of the urinary tract when this fails to opacify during EXU, and appears to be superior to US in demonstrating the level and cause of obstruction.

키워드

참고문헌

  1. Cronan JJ. Contemporary concepts in imaging urinary tract obstruction. Radiol Clin North Am 1991;29:527-542 https://doi.org/10.1016/S0033-8389(22)02716-6
  2. Webb JAW. Ultrasonography in the diagnosis of renal obstruction. Sensitive but not very specific. Br Med J 1990;301:944-946 https://doi.org/10.1136/bmj.301.6758.944
  3. Regan F, Bohlman ME, Khazan R, Rodriguez R, Schultze-Haakh H. MR urography using HASTE imaging in the assessment of ureteric obstruction. AJR 1996;1678:1115-1120 https://doi.org/10.2214/ajr.167.5.8911161
  4. Tang Y, Yamashita Y, Namimoto T, et al. The value of MR urography that uses HASTE sequences to reveal urinary tract disorders. AJR 1996;167:1497-1502 https://doi.org/10.2214/ajr.167.6.8956584
  5. O'Malley ME, Soto JA, Yucel EK, Hussain S. MR urography: evaluation of three-dimenstional fast spin-echo technique in patients with hydronephrosis. AJR 1997;168: 387-392 https://doi.org/10.2214/ajr.168.2.9016213
  6. Nolte-Ernsting CC, Bucker A, Adam GB, et al. Gadolinium-enhanced excretory MR urography after low-dose diuretic injection: comparison with conventional excretory urography. Radiology 1998;209:147-157 https://doi.org/10.1148/radiology.209.1.9769826
  7. Rothpearl A, Frager D, Subramanian A, et al. MR urography: technique and application. Radiology 1995;194:125-130 https://doi.org/10.1148/radiology.194.1.7997538
  8. Hattery RR, King BF. Technique and application of MR urography. Radiology 1995;194:25-27 https://doi.org/10.1148/radiology.194.1.7997563
  9. Roy C, Saussine C, Guth S, et al. MR urography in the evaluation of urinary tract obstruction. Abdom Imaging 1998;23:27-34 https://doi.org/10.1007/s002619900279
  10. Kiefer B, Grassner J, Hausman R. Image acquisition in a second with half-Fourier acquisition single shot turbo spin-echo. J Magn Reson Imaging 1994;4(Suppl.):86-87
  11. Sigmund G, Stoever B, Zimmerhackl LB, Frankenschmidt A, Nitzsche E, Leititis JU. RARE-MR urography in the diagnosis of upper urinary tract abnormalities in children. Pediatr Radiol 1991;21:416-420 https://doi.org/10.1007/BF02026676
  12. Kamholtz RG, Cronan JJ, Dorfman GS. Obstruction and the minimally dilated renal collecting system: US evaluation. Radiology 1989;170:51-53 https://doi.org/10.1148/radiology.170.1.2642347
  13. Hill MC, Rich JI, Mardiat JG, Finder CA. Sonography vs. excretory urography in acute flank pain. AJR 1985;144:1235-1238 https://doi.org/10.2214/ajr.144.6.1235
  14. Malave SR, Neiman HL, Spies SM, Cisternino SJ, Adamo G. Diagnosis of hydronephrosis: comparision of radionuclide scanning and sonography. AJR 1980;135:1179-1185 https://doi.org/10.2214/ajr.135.6.1179
  15. Li W, Chavez D, Edelman RR, Prasad PV. Magnetic resonance urography by breath-hold contrast-enhanced three-dimenstional FISP. J Magn Reson Imaging 1997;7:309-311 https://doi.org/10.1002/jmri.1880070209