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At least 685 records · Page 38Linked to original sources
PubMed2006

Intravenous contrast-enhanced dynamic MR urography: diagnosis of vesicoureteral reflux during bladder filling with time-signal intensity curves.

PURPOSE: To evaluate the time-signal intensity (SI) curves generated from intravenous (IV) gadodiamide-enhanced dynamic magnetic resonance (MR) urographic scans for identifying vesicoureteral reflux (VUR) during bladder filling. MATERIALS AND METHODS: MR urographic studies of children were retrospectively reviewed, and 52 ureterorenal units of 26 patients (15 females and 11 males, mean age = 5.5 years) who had also undergone voiding cystourethrographic (VCUG) examination were included in this study. The patients were examined on a 1.5T scanner. For functional MR urography and to generate time-SI curves, we used a post IV contrast-enhanced two-dimensional (2D) fast field echo (FFE) sequence (TR = 17 msec, TE = 3.2 msec, flip angle (FA) = 90 degrees ) in the coronal plane. MR urographic time-SI curves that demonstrated a prompt and concave fall of the initial third phase followed by intermittent or constantly increasing SI peaks above the baseline from which the second phase starts were considered to have VUR. We compared the differences in time-SI curves between the control group and patients with VUR during bladder filling. RESULTS: Twelve ureterorenal units of eight patients (four bilateral and four unilateral) had VUR during bladder filling on VCUG. The time-SI curves of these patients showed intermittent (N = 8 ureterorenal units), and constantly increasing (N = 4 ureterorenal units) SI peaks consistent with VUR. One patient also had bilateral abnormal time-SI curves suggesting VUR despite the normal VCUG study. In the control group, 25 units had normal triphase time-SI curves, six renal units had urinary dilatation with good washout after diuretic injection, and four renal units had upper urinary dilatation without contrast washout, while five renal units did not show any function. None of the patients in the control group revealed distortion in the time-SI curve. The differences in time-SI curves patterns between the control group and patients with VUR during bladder filling were statistically significant (P < 0.001). CONCLUSION: After a prompt and concave decrease of the initial third phase of the time-SI curve, intermittent spikes or a constant rise in SI above the baseline suggest the existence of VUR.

Case-Control Studies↗
PubMed1994

Image quality and safety in pediatric urography using an ionic and a non-ionic iodinated contrast agent.

The safety and diagnostic efficacy of the new non-ionic, monomeric contrast medium iopentol (Imagopaque) were evaluated and compared with those of the ionic medium metrizoate (Isopaque), in urography in children in a randomized, double-blind, parallel study. The trial comprised 59 children aged from 3 months to 8 years; children with predefined risk factors were not included. The difference in attenuation between the renal and perirenal tissue, assessed from film density measurements, was chosen as the main variable. Diagnostic efficacy was also evaluated subjectively from demarcation of the kidney and the pelvic structures. There was no statistically significant difference between the groups in the diagnostic efficacy. Serious adverse events did not occur in either group. Mild to moderate, transient adverse events were significantly less frequent in the iopentol group than in the metrizoate group, but in no case was medical treatment required. There were no changes or trends toward changes of clinical importance in either group, in serum chemistry variables measured in blood samples taken 2 min after injection of contrast medium compared to baseline values.

Child↗
PubMed1986

Diagnostic role of intravenous urography in acute and chronic renal failure.

High-dose intravenous urography (IVU) was performed 62 times in 59 patients with acute (ARF) and chronic (CRF) renal failure. The major diagnostic categories were chronic glomerulonephritis, malignant hypertension, acute tubular necrosis (ATN), and acute glomerulonephritis. The cause of the renal failure, whether CRF or ARF, oliguric or nonoliguric, could not be reliably determined by either the evolving pattern or density of nephrogram, or the size of the kidneys. Although a persistent dense nephrogram favored the diagnosis of ATN, the major correlate was a decreasing density of nephrogram as the serum creatinine level increased (P less than 0.005).

Acute Kidney Injury↗
PubMed1983

Diuretic radionuclide urography.

Diuretic radionuclide urography is a modification of conventional renography which utilizes the administration of intravenous furosemide to distinguish dilated, non-obstructed, hydronephrotic systems from those with significant mechanical obstruction. Diagnostic patterns are derived from computer generated time-activity histograms that depict the accumulation and washout of radiotracer before and after diuretic injection. In dilated but non-obstructed systems, diuresis produces a decline in activity. In obstructed systems, there is a failure of radiotracer washout in response to diuresis and no decline in activity is observed. The procedure is applicable to patients of all ages with suspected upper urinary tract obstruction. Clinical and experimental data support the accuracy and utility of this methodology and define its limitations and pitfalls.

Animals↗
PubMed1994

A comparative study of evaluating renal scars by 99mTc-DMSA planar and SPECT renal scans, intravenous urography, and ultrasonography.

The purpose of this prospective study is to compare 3 types of 99mTc-DMSA renal scan [(a) planar, (b) x-ray type film static SPECT presentation (SPECT-1) and (c) dynamic three-view display of SPECT slices (SPECT-2)], intravenous urography, and ultrasonography in the diagnosis of renal scars. All these studies were performed in 130 pediatric patients, with urinary tract infection (42 patients), vesicoureteral reflux (37), and unilateral or bilateral small kidney(s) (51). The number of renal scars detected was highest with the 99mTc-DMSA renal SPECT-1 scan and next came the 99mTc-DMSA renal SPECT-2 studies. There is a significant difference (p < 0.05) between the ability of planar and SPECT-1 to recognize renal defects. However, SPECT-2 may provide the best stereotactic localization and image quality of all the methods.

Child, Preschool↗
PubMed1997

[Magnetic resonance urography. First clinical results].

We report our preliminary results using a new magnetic resonance imaging technique for visualization of the urinary tract. Using the paramagnetic contrast medium gadolinium diethylene triamine penta-acetic acid (DTPA), we were able to obtain images of the urinary tract comparable to those obtained by conventional excretory urography. The major advantage of our technique is that besides good morphologic visualization, the excretion of gadolinium-DTPA can be studied simultaneously. We demonstrate our preliminary results in selected cases.

Adult↗
PubMed2005

Reducing dose in urography while maintaining image quality-a comparison of storage phosphor plates and a flat-panel detector.

The introduction of new flat-panel detector technology often forces us to accept too high dose levels as proposed by the manufacturers. We need a tool to compare the image quality of a new system with the accepted standard. The aim of this study was to obtain a comparable image quality for two systems-storage phosphor plates and a flat-panel system using intravenous urography (IVU) as a clinical model. The image quality figure was calculated using a contrast-detail phantom (CDRAD) for the two evaluated systems. This allowed us to set a dose for the flat-panel system that gave equivalent image quality to the storage phosphor plates. This reduced detector dose was used in an evaluation of clinical images to find out if the dose reduction from the phantom study indeed resulted in images of equal clinical image quality. The image quality was assessed using image criteria of the European guidelines for IVU with visual grading analysis. Equivalent image quality in image pairs was achieved at 30% of the dose. The CDRAD contrast-detail phantom makes it possible to find dose levels that give equal image quality using different imaging systems.

Aged↗
PubMed1993

Preliminary evaluation: magnetic resonance of urography using a saturation inversion projection spin-echo sequence.

A saturation inversion projection (SIP) spin-echo technique is reported which allows a reliable direct visualization of the urogenital system as well as its functional performance in magnetic resonance imaging. We used an imaging sequence with a 90 degree saturation pulse and two 180 degree inversion pulses followed by a short spin-echo (SE) pulse sequence. The three time intervals in the 90 degree-180 degree-180 degree-SE pulse train were adjusted to suppress the signals of soft tissues and fat. After intravenous injection of the contrast agent Gd-DTPA, a shortening of the kidney T1 and the T1 of the urogenital system is obtained below the T1 values of fat and soft tissues, and these remaining ultra-short T1 tissues were imaged with the SIP sequence. Using a sequential measuring technique a quantitative evaluation of the glomerular filtration rate seems to be possible with a time resolution of 18 sec per image. In addition, magnetic resonance urography using the SIP sequence provided a good visualization of the urogenital system and may show several clinical utilities in further clinical studies.

Contrast Media↗
PubMed1984

Visibility of the renal fascia at intravenous urography.

Contrary to the accepted understanding that visibility of the perirenal fascia at urography is a rare finding and when seen is usually associated with renal pathology, a recent report has suggested that it is a fairly common, normal finding. In a retrospective study, 261 unselected intravenous urograms performed over a 3-month period were analysed. The findings indicate a low incidence of perirenal fascia visualisation and, when present, an association with renal pathology.

Adult↗
PubMed1986

High- and low-osmolar contrast agents in urography: a comparison of the appearances with respect to pyelotubular opacification and renal length.

The incidence of pyelotubular opacification and the change in renal length during intravenous urography with iohexol (Omnipaque) was compared with sodium/meglumine diatrizoate (Urografin). Pyelotubular opacification was seen in 14 out of 29 urograms performed with iohexol compared with one out of 28 urograms performed with sodium/meglumine diatrizoate. This increased incidence is statistically significant and has not been previously documented. The increase in renal length following intravenous contrast medium was similar for both iohexol and sodium/meglumine diatrizoate. The significance of these findings with respect to the interpretation of urograms performed with iohexol is discussed.

Adult↗
PubMed1992

Sonographic detection of ureteral calculi in patients with normal excretory urography.

We report 3 cases of nonobstructing distal ureteral calculi diagnosed by sonography in which excretory urography was normal. In each case sonography was performed because of high clinical suspicion for a ureteral stone. In 2 patients a stone was impacted at an edematous ureteral orifice. All 3 patients subsequently passed the stone spontaneously. A high resolution ultrasound examination should be performed on patients with a history suggestive of ureteral calculus despite a normal excretory urogram.

Adult↗
PubMed1985

Diuretic radionuclide urography: functional assessment following pyeloplasty.

The radiographic appearance of the hydronephrotic upper urinary tract due to congenital ureteropelvic junction obstruction may not return to normal even though the obstruction is relieved by surgical repair. We present a case of ureteropelvic junction obstruction in which the success of the repair was demonstrated dramatically only by diuretic radionuclide urography.

Adolescent↗
PubMed1980

Assessment of hydroureteronephrosis in children using diuretic radionuclide urography.

Diuretic radionuclide urography was developed as a safe, accurate and non-invasive method of assessing nephroureteral dilatation to distinguish between obstructive and non-obstructive hydronephrosis. The nuclear medicine gamma camera/computer system is used to monitor the washout pattern of an isotope from any locus of suspected obstruction in the upper urinary tract. This technique was used to study 62 children with hydroureteronephrosis of diverse causes. Our experience suggests that it is accurate in determining whether true obstruction exists in dilated systems and effective in predicting which patients will benefit from corrective operation.

Adolescent↗
PubMed1978

Preoperative evaluation of patients with bladder outlet obstruction with particular regard to excretory urography.

During the last 15 years excretory urography has been a routine preoperative diagnostic procedure for patients with bladder outlet obstruction in our department and, perhaps, for many more years in other urological centers. There are 2 reasons that this investigation should be done: 1) to detect abnormalities of the upper urinary tract that can be important indicators to operate or for the postoperative course and 2) to detect abnormalities in the bladder that should be corrected simultaneously with the prostatectomy or that can interfere with the procedure.

Aged↗
PubMed1987

The reliability of excretory urography as a screening examination for blunt renal trauma.

A prospective study was designed to evaluate the reliability of excretory urography (EU) in excluding renal damage in patients with blunt abdominal trauma, using contrast-enhanced computed tomography (CECT) as the "gold standard" of diagnostic studies. Sixty patients with indications for genitourinary evaluation and with normal EU underwent CECT. Five renal injuries were demonstrated by CECT in patients with negative EU: one contusion, one subcapsular hematoma, two perirenal hematomas, and one renal laceration. All of these lesions resolved with conservative patient management. Thus, the CECT findings did not alter treatment in these five patients.

Adolescent↗
PubMed2000

Are dedicated bladder films necessary as part of intravenous urography for haematuria?

OBJECTIVE: To determine the use and assess the value of full-bladder films during intravenous urography (IVU) which, despite the widespread availability of flexible cystoscopy, remain part of IVU in many radiology departments. Materials and methods A telephone survey of all Scottish radiology departments where IVU is regularly used showed that half routinely included a full-bladder film in the series. The reports of all IVU over 2 years in the authors' department were analysed retrospectively. The index urogram of all patients with bladder tumours confirmed during this period was reviewed independently by three observers, and together with the initial radiological reports was correlated with the cystoscopic and histological findings. RESULTS: From 2625 patients, 139 (5.2%) IVU reports commented on the bladder; 1423 patients presented with no haematuria. None of the patients without haematuria, where a comment was made about the bladder, had pathological evidence of a tumour. Overall 121 of 464 (26%) new bladder tumours were diagnosed on IVU before cystoscopy. Multiple tumours were always undetected and large tumours were often overlooked. CONCLUSIONS: Despite its continuing popularity, IVU is a poor means of identifying bladder tumours and routine views of the full bladder should be abandoned.

Health Surveys↗
PubMed2002

MR urography: evaluation of different techniques in non-dilated tracts.

OBJECTIVE: To assess the effectiveness of different MRI sequences for the visualisation of the different components of the non-dilated urinary tract. METHOD: 20 asymptomatic individuals were prospectively evaluated using 2 different heavily T2 weighted sequences, and after the injection of 2 different doses of gadolinium (Gd-DTPA). Images were independently scored. RESULTS: The low dose Gd-DTPA enhanced MR urography (MRU) sequence was the best overall sequence for the visualisation of both the pelvicalyceal systems and ureters. The combination of information from the other sequences was additive. CONCLUSIONS: Combined use of heavily T2 weighted and Gd-DTPA enhanced MRU produces diagnostic images and does not require pre-imaging preparation other than oral hydration.

Adult↗
PubMed1992

[Ureteropelvic stenosis in infancy. The value of diuresis sonography compared with diuresis excretory urography].

Examinations under conditions of diuresis produced by drugs can be useful to differentiate pyelo-ureteric obstruction from a dilated collecting system with normal flow. 22 infants with 42 kidneys showing moderate dilatation of one of both renal collecting systems were examined by sonography and excretory urography under conditions of diuresis and the results were compared. Depending on the radiological appearances and contrast clearance rates, four diagnostic groups could be identified; these also differed significantly on the sonographic examinations. In general, there was good agreement between the two methods. Carefully performed, diuresis sonography will clearly distinguish between urodynamically significant obstruction from a wide but non-obstructive collecting system. The number of radiographic examinations can therefore be reduced in these patients.

Diagnosis, Differential↗