MRI in patients with chronic obstructive uropathy and compromised renal function: a sole method for morphological and...

Area of Science:

• Radiology
• Nephrology
• Medical Imaging

Background:

• Chronic obstructive hydronephrosis impacts renal function.
• Accurate anatomical and functional assessment is crucial for managing compromised renal function.

Purpose of the Study:

• To evaluate magnetic resonance urography (MRU) as a single modality for assessing obstructed kidneys in patients with impaired renal function.
• To compare MRU-derived glomerular filtration rate (GFR) with isotope GFR.

Main Methods:

• Gadolinium-enhanced MRI (Gd-MRI) was performed on 96 adults with obstructive hydronephrosis and compromised renal function.
• MRU assessed renoureteral anatomy and calculated individual GFR.
• Technetium-99m diethylenetriamine-pentaacetic acid renal scans were used for comparison.

Main Results:

• MRU detected non-calcular obstruction with 100% sensitivity and calcular obstruction with 70% sensitivity.
• Combined MRI, X-ray, and ultrasound sensitivity for obstruction detection was 97%.
• A perfect correlation was observed between MRU GFR and isotope GFR.

Conclusions:

• Combined static and dynamic MRU is a promising technique for evaluating obstructed kidneys in patients with impaired renal function.
• Careful use of gadolinium contrast is advised for patients with GFR <30 ml/min to mitigate nephrogenic systemic fibrosis risk.