IJCM  Vol.7 No.5 , May 2016
Comparison of Magnetic Resonance Urography (MRU) with Intravenous Pyelography (IVP) in Evaluation of Patients with Hydronephrosis on Ultrasonography Due to Pelvi-Ureteric Junction Obstruction
Abstract: The objective of this study was to compare Magnetic Resonance Urography (MRU) with Intravenous Pyelography (IVP) in evaluation of patients with hydronephrosis on ultrasonography. 49 patients of hydronephrosis on USG were enrolled for the study from Jan. 2011 to Dec. 2012. All patients under went Intravenous Urography (IVU). MRU was done to determine the anatomical details and function of each renal unit. MRU was performed on a 1.5 tesla unit (Magneton Avento; Siemens, Erlangen, Germany). Static T2-weighted Magnetic Resonance Urography (MRU) was performed by using a standard fast spin echo technique. Dynamic study was performed after injecting intravenous diuretic followed by Gadolinium contrast media. Morphological results of MRU were compared with IVU. The anatomical findings were compared with operative findings. Stastical analysis was performed and data expressed as mean ± SD. MRU showed PUJ obstruction in 41 out of 45 patients (91.1%). We concluded that MRU can provide complete diagnostic evaluation of entire urinary tract in a single session and has potential to replace IVP.
Cite this paper: Ahmad Bhat, G. , Ahmad Reshi, T. and Rashid, A. (2016) Comparison of Magnetic Resonance Urography (MRU) with Intravenous Pyelography (IVP) in Evaluation of Patients with Hydronephrosis on Ultrasonography Due to Pelvi-Ureteric Junction Obstruction. International Journal of Clinical Medicine, 7, 353-360. doi: 10.4236/ijcm.2016.75038.

[1]   Klahr, S. (1999) The Geriatric Patient with Obstructive Uropathy. Geriatric Nephrology and Urology, 9, 101-107.

[2]   Gulmi, F.A., Felson, D. and Vaughan, E.D. (1998) The Pathophysiology of Urinary Tract Diseases. Campbells Urology, 342-385.

[3]   Murnaghan, G.F. (1958) The Dynamics of the Renal Pelvis and Ureter with Reference to Congenital Hydronephrosis. British Journal of Urology, 30, 321-324.

[4]   Hanna, J.K. (2000) Antenatal Hydronephrosis and Ureteropelvic Junction Obstruction: The Case for Early Intervention. Urology, 55, 612-615.

[5]   Jara, H., Barish, E.K., Yucel, E.R., Melhem, S., Hussain, J. and Ferrucci, T. (1998) MR Hydrography. Theory and Practice of Static Fluid Imaging. American Journal of Roentgenology, 170, 873-882.

[6]   Lauterber, P.C. (1973) Image Formation by Induced Local Interaction: Examples of Employing Nuclear Magnetic Resinanace. Nature, 242, 190-191.

[7]   O’Malley, M.E., Soto, J.A., Yucel, E.K. and Hussain, S. (1997) MR Urography: Evaluation of a Three-Dimensional Fast Spin-Echo Technique in Patients with Hydronephrosis. American Journal of Roentgenology, 168, 387-392.

[8]   Bassignani, M.J. (2006) Understanding and Interpreting MRI of the Genito-Urinary Tract. Urologic Clinics of North America, 33, 135-151.

[9]   Valtuille, G.R., Ai-Valtuille, G., Abascal, F., Cerezal, L. and Arguello, M.C. (2006) Magnetic Resonance Urography: A Pictorial Overview. British Journal of Radiology, 79, 614-626.

[10]   Murphy, K.J., Brunberg, J.A. and Cohan, R.H. (1996) Adverse Reactions to Gadolinium Contrast Media: A Review of 36 Cases. American Journal of Roentgenology, 167, 847-849.

[11]   Runge, V.M. (2001) Safety of Magnetic Resonance Contrast Media. Topics in Magnetic Resonance Imaging, 12, 309-314.

[12]   Marckmann, P., Skov, L., Rossen, K., Dupont, A., Damholt, M.B., Heaf, J.G., et al. (2006) Nephrogenic Systemic Fibrosis: Suspected Etioliogy Role of Gadodiamide Used for Contrast Enhanced MRIJ. American Society of Nephrology, 17, 2359-2362.

[13]   Grobner, T. (2006) Gadolinium—A Specific Trigger for the Development of Nephrogenic Systemic Fibrosis. Nephrology Dialysis Transplantation, 21, 1104-1108.

[14]   Katzberg, R.W., Buonocore, M.H., Ivanovic, M., et al. (2001) Functional, Dynamic, and Anatomic MR Urography: Feasibility and Preliminary Findings. Academic Radiology, 8, 1083-1099.

[15]   Martin, X. and Rouvière, O. (2001) Radiologic Evaluations Affecting Surgical Technique in Ureteropelvic Junction Obstruction. Current Opinion in Urology, 11, 193-196.

[16]   Zamparelli, M., Cobellis, G., Rossi, L., Valeri, G., Amici, G. and Martino, A. (2003) Detection of Crossing Vessels at the Ureteropelvic Junction with Fast MRI. Pediatria Medica e Chirurgica, 25, 50-52.

[17]   Shokeir, A.A., El-Diasty, T.A., Eassa, W., Mosbah, A., El-Ghar, M.A., Mansour, O., et al. (2004) Diagnosis of Ureteral Obstruction in Patients with Compromised Renal Function: The Role of Noninvasive Imaging Modalities. Journal of Urology, 171, 2303-2306.

[18]   Public Health Advisory: Gadolinium Containing Contrast Agents for Magnetic Resonance Imaging: Omniscan, OptiMARK, Magnevest, Prohance and Multihance. US Food and Drug Administration, Centre for Drug Evaluation and Research.

[19]   El-Diasty, T., Mansour, O. and Farouk, A. (2003) Diuretic Contrast-Enhanced Magnetic Resonance Urography versus Intravenous Urography for Depiction of Nondilated Urinary Tracts. Abdominal Imaging, 28, 135-145.

[20]   Wolf, G.L., Hoop, B., Cannillo, J.A., Rogowska, J.A. and Halpern, E.F. (1994) Measurement of Renal Transit of Gadopentate Dimeglumine with Echo-Planar MR Imaging. Journal of Magnetic Resonance Imaging, 4, 365-372.

[21]   Nortier, J. and del Marmol, V. (2007) Nephrogenis Systemic Fibrosis—The Need for a Multidisciplinary Approach. Nephrology Dialysis Transplantation, 22, 3097-3101.

[22]   Baron, P.W., Cantos, K., Hillebrand, D.J., Hu, K.Q., Ojogho, O.N., Nehlsen-Cannarella, S., et al. (2003) Nephrogenic Fibrosing Dermopathy after Livertransplantion Successfully Treated with Plasmopheresis. American Journal of Dermatopathology, 25, 204-209.