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Evaluation of differential renal function in children - a comparative study between magnetic resonance urography and
Małgorzata Gołuch1, Agnieszka Pytlewska2, Jędrzej Sarnecki3
1Department of Diagnostic Imaging, The Children's Memorial Health Institute, Warsaw, Poland. malg.goluch@gmail.com.
Insights
Magnetic resonance urography (MRU) accurately measures differential renal function in children, showing excellent agreement with dynamic renal scintigraphy (DRS). This finding supports MRU
Area of Science:
- Pediatric Radiology
- Diagnostic Imaging
- Nephrology
Background:
- Congenital and acquired urinary system anomalies are common in children.
- Early diagnosis via imaging is crucial for preventing chronic kidney disease.
- Dynamic renal scintigraphy (DRS) is a standard for assessing renal function.
Purpose of the Study:
- To evaluate the utility of magnetic resonance urography (MRU) in pediatric urinary system assessment.
- To compare differential renal function calculated by MRU with DRS.
- To determine if MRU can serve as a reliable alternative to DRS.
Main Methods:
- 46 pediatric patients (1 week-17 years) underwent both DRS and MRU.
- Differential renal function was calculated using MRU with dedicated software (CHOP-fMRU and pMRI).
- MRU results were analyzed for agreement with DRS and for inter/intraobserver reliability.
Main Results:
- Excellent agreement was observed between MRU (CHOP-fMRU and pMRI) and DRS for differential renal function (Pearson's r > 0.97).
- High interclass correlation coefficients (ICC > 0.969) confirmed strong agreement.
- pMRI showed excellent intraobserver (ICC 0.996) and interobserver (ICC 0.992) reliability.
Conclusions:
- MRU demonstrates high utility and accuracy in evaluating pediatric urinary systems.
- No significant differences were found between MRU and DRS in calculating differential renal function.
- MRU is a valuable, reliable tool for assessing renal function in children.
Background:
Urinary system anomalies, both congenital and acquired, constitute a relatively common clinical problem in children. The main role of diagnostic imaging is to determine early diagnosis and support therapeutic decisions to prevent the development of chronic renal disease. The aim of this study was to evaluate the utility of magnetic resonance urography (MRU) in assessment of urinary system in children, by comparing differential renal function calculated using MRU with dynamic renal scintigraphy (DRS).
Materials And Methods:
The study group consisted of 46 patients aged 1 week to 17 years (median 7 (0.5; 13) years, 17 (37%) girls, 29 (63%) boys), who underwent dynamic renal scintigraphy due to various clinical reasons. All participants underwent MRU, which was used to measure differential renal function. Functional analysis was performed using dedicated external software (CHOP-fMRU and pMRI without prior knowledge of DRS results. MRU results acquired using pMRI were assessed for inter and intraobserver agreement.
Results:
Statistical analysis of the results showed excellent agreement between MRU and DRS in measuring differential renal function with Pearson correlation coefficient 0.987 for CHOP-fMRU and 0.971 for pMRI, p < 0.001. Interclass correlation coefficient (ICC) for these programs was 0.987 (95% CI 0.976-0.993) and 0.969 (95% CI 0.945-0.983) respectively, p < 0.001. The Bland-Altman 95% limits of agreement for CHOP-fMRU results vs. DRS was - 6.29-5.50 p.p. and for pMRI results vs. DRS - 9.15-9.63 p.p. The differential renal function measurements calculated in pMRI showed excellent intraobserver and interobserver agreement with ICC 0.996 (95% CI 0.994-0.998) and 0.992 (95% CI 0.986-0.996) respectively, p < 0.001.
Conclusions:
The study showed no significant differences between magnetic resonance urography and dynamic renal scintigraphy in calculating differential renal function. It indicates high utility of MRU in the evaluation of urinary system in children.
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