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[Gadolinium-enhanced T(1)-weighted MR urography versus T(2)-weighted (HASTE) MR urography in children]

G Staatz1, C C Nolte-Ernsting, P Haage

  • 1Klinik für Radiologische Diagnostik, Universitätsklinikum der RWTH Aachen. staatz@rad.rwth-aachen.de

Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|November 13, 2001
PubMed

Insights

Gadolinium-enhanced MR urography (EMRU) offers superior accuracy for most pediatric urinary tract abnormalities. T(2)-weighted MR urography (HASTE) is best for non-functioning kidneys and cystic diseases, complementing EMRU.

Area of Science:

  • Pediatric Radiology
  • Urogenital Imaging
  • Magnetic Resonance Imaging

Background:

  • Upper urinary tract abnormalities are common in children.
  • Accurate diagnosis is crucial for appropriate management and outcomes.
  • MR urography offers a non-invasive imaging modality for evaluating these conditions.

Purpose of the Study:

  • To compare the diagnostic accuracy of gadolinium-enhanced T(1)-weighted excretory MR urography (EMRU) versus T(2)-weighted (HASTE) MR urography.
  • To evaluate these techniques in children with various upper urinary tract abnormalities.

Main Methods:

  • Prospective study of 63 children (3 weeks to 15 years) using a 1.5-T scanner.
  • T(2)-weighted (HASTE) images acquired before and after furosemide.
  • Gadolinium-enhanced T(1)-weighted EMRU performed after gadolinium injection using 3D-gradient-echo sequences.

Main Results:

  • EMRU showed superior diagnostic accuracy for non-dilated collecting system abnormalities (e.g., horseshoe kidneys, duplex systems).
  • Both EMRU and T(2)-weighted MRU were equivalent for assessing obstructed but functioning upper tracts (e.g., UPJ obstructions).
  • T(2)-weighted MRU was optimal for visualizing non-functioning dilated collecting systems and multicystic dysplastic kidneys.

Conclusions:

  • Respiratory-gated gadolinium-enhanced T(1)-weighted MRU accurately evaluates most pediatric upper urinary tract abnormalities.
  • T(2)-weighted (HASTE) MRU serves as a valuable complement to EMRU for assessing non-functioning renal units and cystic kidney diseases.
Abstract

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