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.
Highlights
Obstructive uropathy is the structural or functional abnormality in urinary tract that impedes the normal flow of urine
Pelviureteric junction obstruction (PUJO) is a condition in which urine is unable to travel from the renal pelvis to the bladder because of a blockage occurring at the UPJ
Static Magnetic Resonance Urography (MRU) is very accurate in diagnosing the level and cause of obstruction, especially if the obstruction is not caused by calculi [17] but can not provide information about renal function
Summary
Obstructive uropathy is the structural or functional abnormality in urinary tract that impedes the normal flow of urine. Tumors, strictures and anatomical abnormalities and can result in pain, urinary tract infection, loss in renal function, or possibly sepsis and death [1]. Progressive back pressure on the kidneys and ureters can occur and cause hydroureter and hydronephrosis. Hydronephrosis causes permanent nephron damage and renal failure [2]. Pelviureteric junction obstruction (PUJO) is a condition in which urine is unable to travel from the renal pelvis to the bladder because of a blockage occurring at the UPJ. A congenital PUJ obstruction may be due to either an intrinsic or an extrinsic cause, or in some cases, both [3]. The strategy for management of renal obstruction is based upon precise delineation of the anatomy of both Reno-ureteral units, as well as accurate estimation of the split renal function
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