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The use of dynamic magnetic resonance imaging to evaluate orthotopic continent urinary diversion
C M Tempany1, F A Masoudi, F F Marshall
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Objectives:
The purpose of this study was to evaluate a dynamic magnetic resonance (MR) examination in patients after radical cystoprostatectomy with a neobladder.
Methods:
All 12 subjects were studied with the injection of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) and showed normal renal enhancement patterns and upper urinary tracts, except 1 patient who had mild right hydronephrosis. All neobladders were also visualized with gadolinium and 9 of 11 patients were able to void on command. There was close agreement in all cases with the MR findings and other imaging studies.
Results:
A static and dynamic Gd-DTPA contrast medium MR did image the entire urinary system, similar to a computed tomographic scan or intravenous urogram. Renal function data, similar to a renal radioisotope scan, was obtained from the Gd-DTPA scans. A dynamic voiding study provided visualization of the lower genitourinary tract similar to a conventional voiding cystourethrogram.
Conclusions:
We conclude that this single MR technique may provide information similar to that obtained from multiple standard imaging studies in the postoperative assessment of the radical cystectomy patient with a neobladder. It may be especially helpful in the presence of azotemia or contrast allergy.