Interactive magnetic resonance imaging for paediatric vesicoureteric reflux (VUR)

Abstract Objectives The current gold standard for diagnosing vesicoureteric reflux in unsedated infants is the X-ray-based Micturating CystoUrethroGram (MCUG). The aim of this study was to assess the diagnostic performance of interactive MRI for voiding cysto-urethrography (iMRVC). Methods 25 infant...

Full description

Saved in:
Bibliographic Details
Published in:European journal of radiology 2013-03, Vol.82 (3), p.e112-e119
Main Authors: Arthurs, Owen J, Edwards, Andrea D, Joubert, Ilse, Graves, Martin J, Set, Pat A.K, Lomas, David J
Format: Article
Language:English
Subjects:
Algorithms
Female
Humans
Image Enhancement - methods
Infant
Infant, Newborn
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Micturating cystourethrogram
Observer Variation
Paediatric
Radiology
Reproducibility of Results
Sensitivity and Specificity
User-Computer Interface
Vesico-Ureteral Reflux - pathology
Vesicoureteral reflux
Vesicoureteric reflux
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Objectives The current gold standard for diagnosing vesicoureteric reflux in unsedated infants is the X-ray-based Micturating CystoUrethroGram (MCUG). The aim of this study was to assess the diagnostic performance of interactive MRI for voiding cysto-urethrography (iMRVC). Methods 25 infants underwent conventional MCUG followed by iMRVC. In iMRVC, patients were examined using a real-time MR technique, which allows interactive control of image contrast and imaging plane location, before, during and after micturition. Images were assessed for presence and grade of VUR. Parental feedback on both procedures was evaluated. Results iMRVC gave a sensitivity of 100%, specificity of 90.5% (95% CI: 81.6–99.4%), PPV of 66.7% and NPV of 100% in this population. There was 88% concordance (44/50 renal units) according to the presence of VUR between the two methods, with iMRVC up-grading VUR in 6 units (12%). There was very good agreement regarding VUR grade: Kappa = 0.66 ± 0.11 (95% CI 0.43–0.88). 60% of parents preferred the MRI, but did not score the two tests differently. Conclusion Interactive MRI allows dynamic imaging of the whole urinary tract without ionising radiation exposure. iMRVC gives comparable results to the MCUG, and is acceptable to parents.
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2012.10.024