Abstract
To evaluate gadolinium-enhanced T(1)-weighted excretory MR urography (EMRU) versus T(2)-weighted (HASTE) MR urography in children with upper urinary tract abnormalities. In a prospective study 63 children, aged from 3 weeks to 15 years, underwent MR urography in a 1.5-T scanner. Before and after an intravenous injection of 0.05 mg/kg body weight of furosemide, respiratory-triggered HASTE images were obtained for T(2)-weighted MR urography. EMRU was performed subsequent to i. v. gadolinium injection with respiratory-gated, coronal 3 D-gradient-echo sequences. Compared to T(2)-weighted (HASTE) MR urography, gadolinium-enhanced MR urography revealed a superior diagnostic accuracy in non-dilated collecting systems (horseshoe kidneys, ectopic kidneys, duplex systems, single ectopic ureters, ureteroceles). EMRU and T(2)-weighted (HASTE) MRU turned out to be equivalent in the assessment of obstructed but normal functioning upper urinary tracts (UPJ obstructions, megaureters). Non-functioning dilated collecting systems and multicystic dysplastic kidneys were best visualized with use of T(2)-weighted (HASTE) MR urography. Respiratory-gated gadolinium-enhanced T(1)-weighted MRU allows accurate evaluation of most upper urinary tract abnormalities. T(2)-weighted (HASTE) MRU complements GMRU in the evaluation of non-functioning renal units and cystic disease of the kidneys.
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