Urology · 2013
The role of static magnetic resonance urography in the evaluation of obstructive uropathy.
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Muthusami Prakash, Bhuvaneswari Venkatesan, Elangovan Sundararajan, Dorairajan Lalgudi N, Ramesh Ananthakrishnan
Аннотация
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.
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.