Vadivalagia Nambi Sivakumar1, Venkatraman Indiran2, Babu Peter Sathyanathan3. 1. Department of Radiodiagnosis, Meenakshi Medical College Hospital and Research Institute, Enathur, Karrapettai Post, Tamilnadu, India. 2. Department of Radiodiagnosis, Sree Balaji Medical College and Hospital 7 Works Road, Chromepet Chennai, Tamilnadu, India. 3. Department of Radiodiagnosis, Barnard Institute of Radiology, Madras Medical Collège, Chennai, Tamilnadu, India.
Abstract
OBJECTIVE: The aim of this study was to evaluate and compare the diagnostic accuracy of dynamic contrast- enhanced magnetic resonance imaging (dMRI) and isotope renogram in the functional evaluation of pelviureteric junction obstruction (PUJO). MATERIAL AND METHODS: Forty-two patients included in the study were investigated with isotope renogram and subsequently, subjected to dMRI. Time-activity curves were generated for both isotope renogram and dMRI. Out of the 42 cases, 9 cases were conservatively managed. Thirty-three cases were taken up for surgical intervention. RESULTS: Of 33 patients taken up for surgical intervention, 12 underwent laparoscopic nephrectomy and 21 of them pyeloplasty. The mean glomerular filtration rates (GFRs) as measured by isotope renogram and dMRI were 22.5+4.2 mL/min and 23.8+3.1 mL/min respectively. The calculation of GFR by isotope renogram, showed good correlation with that of dMRI with correlation coefficient of 0.93. The dMRI was able to reveal the functional status of the renal unit accurately. dMRI did not yield false positive results with 20 of 21 patients scheduled for pyeloplasty and 11 of 12 patients scheduled for nephrectomy. Isotope renogram had a false positive result in 3 cases compared with surgical diagnosis. CONCLUSION: Analysis of renal function using dMRI yielded results comparable to those of renal scintigraphy, with superior spatial and contrast resolution. It was also better in prompting management decisions with respect to the obstructed systems. dMRI can be used as a "one stop imaging examination" that can replace different imaging methods used for morphological, etiological and functional evaluation of PUJO.
OBJECTIVE: The aim of this study was to evaluate and compare the diagnostic accuracy of dynamic contrast- enhanced magnetic resonance imaging (dMRI) and isotope renogram in the functional evaluation of pelviureteric junction obstruction (PUJO). MATERIAL AND METHODS: Forty-two patients included in the study were investigated with isotope renogram and subsequently, subjected to dMRI. Time-activity curves were generated for both isotope renogram and dMRI. Out of the 42 cases, 9 cases were conservatively managed. Thirty-three cases were taken up for surgical intervention. RESULTS: Of 33 patients taken up for surgical intervention, 12 underwent laparoscopic nephrectomy and 21 of them pyeloplasty. The mean glomerular filtration rates (GFRs) as measured by isotope renogram and dMRI were 22.5+4.2 mL/min and 23.8+3.1 mL/min respectively. The calculation of GFR by isotope renogram, showed good correlation with that of dMRI with correlation coefficient of 0.93. The dMRI was able to reveal the functional status of the renal unit accurately. dMRI did not yield false positive results with 20 of 21 patients scheduled for pyeloplasty and 11 of 12 patients scheduled for nephrectomy. Isotope renogram had a false positive result in 3 cases compared with surgical diagnosis. CONCLUSION: Analysis of renal function using dMRI yielded results comparable to those of renal scintigraphy, with superior spatial and contrast resolution. It was also better in prompting management decisions with respect to the obstructed systems. dMRI can be used as a "one stop imaging examination" that can replace different imaging methods used for morphological, etiological and functional evaluation of PUJO.
Authors: Benjamin B McDaniel; Richard A Jones; Hal Scherz; Andrew J Kirsch; Stephen B Little; J Damien Grattan-Smith Journal: AJR Am J Roentgenol Date: 2005-12 Impact factor: 3.959
Authors: J G Wen; Y Chen; S Ringgaard; J Frøkiaer; T M Jørgensen; H Stødkilde-Jørgensen; J C Djurhuus Journal: J Urol Date: 2000-04 Impact factor: 7.450