Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S5-12

(P)

DYNAMIC CONTRAST ENHANCED MAGNETIC REASONANCE NEPHRO-UROGRAPHY

IN DETERMINATION OF SPLIT RENAL FUNCTION IN PEDIATRIC OBSTRUCTIVE

UROPATHY

Haytham BADAWY

, Nada ELKAYAL

, Mohammed EID

, Rafik IBRAHIM

and Adel RAMDAN

1) University of Alexandria, Ped-urology, Alexandria, EGYPT - 2) University of Alexandria, Radiology, Alexandria, EGYPT

PURPOSE

The aim of our study was to evaluate the role of dynamic enhanced MRI and compare it to other imaging modalities in

the investigation of pediatric hydronephrosis.

MATERIAL AND METHODS

Twenty-four patients (13 boys and 11 girls, mean age 4 years [2 months-14 years] with unilateral or bilateral urinary

tract dilatation underwent prospective examination with combined static-dynamic MR urography. A combination

examination involved use of a static T2 weighted Turbo Spin Echo sequences and a dynamic T1-weighted Gradient Echo

three-dimensional sequence with a dose of 0.05-0.1mmol/kg gadopentetate dimeglumine-DTPA and furosemide

application. The morphological and functional results were compared with those of ultrasonography, scintigaraphy and,

when available, conventional urography. Results were compared with those of diuretic renal scintigraphy (DRS) for split

function (Pearson correlation coefficient) and urinary excretion (Agreement (k) coefficient).

RESULTS

pelvi-ureteric junction obstruction (n= 11), non-obstructive dilatation post-pyeloplasty (n= 5), primary megauereter

(n=3) and duplex system (n=3).For split renal function, dynamic MR urography and DRS showed strong correlation (r=

0.89, P<0.0001). For urinary excretion, based on the excretory segment of the Reno graphic curve, MR urography and

DRS showed strong agreement (k= 0.63), with concordant classification of urinary excretion in 21 (78%) of 27

abnormal kidney-ureter units.

CONCLUSIONS

Combined static-dynamic MR urography provides high-quality depiction of the urinary tract in infants and children, as

well as accurate determination of split kidney function and reliable evaluation of urinary excretion in a single test.