The Role of Static Magnetic Resonance Urography in the Evaluation of Obstructive Uropathy

Objective To assess the diagnostic accuracy of static magnetic resonance urography (MRU) in hydronephrosis and to compare parameters of hydronephrosis in MRU with intravenous urography (IVU). Materials and Methods Sixty-nine patients were included in this study of which 55 patients with a total of 6...

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Published in:Urology (Ridgewood, N.J.) N.J.), 2013-03, Vol.81 (3), p.623-628
Main Authors: Muthusami, Prakash, Bhuvaneswari, Venkatesan, Elangovan, Sundararajan, Dorairajan, Lalgudi N, Ramesh, Ananthakrishnan
Format: Article
Language:English
Subjects:
Biological and medical sciences
Female
Humans
Hydronephrosis - diagnosis
Magnetic Resonance Imaging
Male
Medical sciences
Nephrology. Urinary tract diseases
Prospective Studies
Reproducibility of Results
Ureteral Obstruction - diagnosis
Urography - methods
Urology
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Summary:Objective To assess the diagnostic accuracy of static magnetic resonance urography (MRU) in hydronephrosis and to compare parameters of hydronephrosis in MRU with intravenous urography (IVU). Materials and Methods Sixty-nine patients were included in this study of which 55 patients with a total of 63 hydronephrotic units underwent both IVU and MRU. MRU was performed on a 1.5 T scanner using heavily T2-weighted sequences. The level, grade, and cause of obstruction on each modality were interpreted by 2 radiologists. These were compared with the final diagnosis based on other appropriate modalities including imaging, intraoperative and histopathologic diagnosis. Results The sensitivity and specificity MRU in detecting hydronephrosis were 95% and 100%, respectively. In determining the level of obstruction, the strength of agreement between IVU and MRU using kappa statistics was κ = 0.66, which corresponds to a good level of agreement. The Spearman correlation coefficient for the grade of hydronephrosis on MRU and IVU was 0.92 (95% confidence interval 0.86–0.95), with a P value of < .0001. The correct diagnosis was made in 89.2% of the cases by IVU and in 93.8% of the cases by MRU. Conclusion Along with a high sensitivity and specificity in detecting the presence, level, and grade of hydronephrosis, MRU without contrast also shows a good agreement with IVU. Static MRU can reliably replace IVU when the latter is contraindicated or technically difficult.
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2012.10.051