NON-CONTRAST MAGNETIC RESONANCE UROGRAPHY- A PROSPECTIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 86
Abstract
BACKGROUND The key element, iodine set the stage for all future developments in contrast material for radiographic imaging. From this stage, extensive development of the quality of contrast medium has grown immensely to the present stage of non-ionic contrast media which are considered to be safe. The aims of this study are1. To study the efficacy of static MR urography in comparison with conventional urography. 2. To study the levels and causes of obstruction of urinary tract by MR urography and compare them with other investigation procedures. MATERIALS AND METHODS 120 patients who presented with clinical symptoms and signs pertaining to renal diseases and were positive on conventional MRI from Department of Radiodiagnosis, Osmania Medical College/ Hospital, Hyderabad, were selected for this study. This is an Institution-based cross-sectional study. MRU was performed on SIGNA HD 1.5 Tesla MRI, GE Healthcare (Milwaukee, USA). A body coil and commercially available software were used. SIGNA HD 1.5T is a diagnostic imaging device, which generates and displays transverse, sagittal, coronal and paraxial whole body images. Before performing MR urography, 3-plane localiser obtained in three planes was used to confirm optimum patient positioning; axial and coronal T2 weighted single shot FSE sequences of KUB region were taken, (TR 1615 msec, TE 88 msec, FOV 38 x 38, Matrix 256 x 256, NEX 0.56, TA 49 sec). The imaging method was based on the physical principle of magnetic resonance (MR). During the measurement, the patient was placed on the strong homogeneous magnetic field. The hydrogen nuclei (protons) distributed throughout the entire body tissue generate signals when stimulated by an RF field. These signals were processed into images by a computer. RESULTS In our study, 3D respiratory triggered sequences 3D FR FSE (Fast Recovery Fast Spin Echo) sequence was used. It provides high signal intensity of fluid even with short repetition time. After signal decay at end of echo train, a negative 90 degree pulse align spins with long T2 from transverse plane to longitudinal plane leading to a much faster recovery of tissues with long T2 time to equilibrium and thus better contrast between tissues with long and short T2. A frequency-selective fat-saturation pulse was used to reduce signal from retroperitoneal fat. During a period of 3 years, a total of 120 patients formed the study group. This included 52 females (43%) and 68 males (57%). Most patients in this study group belonged to the 3rd decade. Commonest complaint in this study was pain followed by dysuria. MR Urography images were of relatively good quality. Distension of urinary bladder aided in better visualisation of upper urinary tract. We had considerable difficulty in removal of overlying bowel from images of few patients. Renal sizes could be easily measured, renal contours were normal, no masses and other parenchymal abnormalities were seen. Calyceal, forniceal and infundibular anatomy was not seen with the same detail as with an IVU. Anatomy of retroperitoneal and adjacent organs were reasonably seen. CONCLUSION In conclusion, MR urography provides high quality imaging of urinary tract and is an accurate and safe diagnostic alternative to other urological procedures. This when combined with excretory MRU, conventional MR images and MRA in a single session can yield a rapid and complete diagnostic evaluation of urinary tract and have the potential to provide the same information as can be obtained with multiple separate diagnostic studies.
Authors and Affiliations
Aswini Jyothi J. S, Vijaya Kumari M, Jayalatha N
Keywords
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- EP ID EP277648
- DOI 10.14260/jemds/2017/1300
- Views 95
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