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PubMedDate not supplied

Outcome of intravenous urography in the year 2000.

BACKGROUND: We studied the referrals for intravenous urography and their outcome during the year 2000 in a university department before the switch to unenhanced computed tomography (CT) and CT urography. METHODS: From the Radiology Information System, we obtained information about age, sex, referring physician, indication, and diagnosis. RESULTS: A total of 1229 intravenous urographies was performed in 1164 patients. In patients younger than 40 years, females were examined more frequently than males, and vice versa. Forty-five percent of all patients were referred with renal colic, and 41% were referred with hematuria. Renal colic was a more frequent indication than hematuria in patients younger than 61 years, whereas the opposite was the case in patients older than 60 years. Of the 559 urographies performed due to renal colic, a calculus in the upper urinary tract was found in 27% and a change indicating a tumor in 4%; the incidence of calculus increased with age up to 80 years. Of the 487 urographies performed due to hematuria, a calculus in the upper urinary tract was found in 6% and a change indicating a tumor in 15%. In the 277 patients younger than 40 years, an abnormality was diagnosed in 25% and a potential tumor was diagnosed in only 1.4%. The latter could not be confirmed at other examinations. Of the 887 patients older than 40 years, an abnormality was found in 45% and a potential tumor in 11%. CONCLUSION: A switch from urography to unenhanced CT and CT urography should not be done without an audit of the referrals and their outcomes. Patients with hematuria and younger than 40 years seem more appropriate for ultrasound than for CT because the incidence of tumors and calculus disease is low. No transitional cellular cancer was found in these patients.

Colic↗

PubMed2001

Feasibility of MR urography in neonates and infants with anomalies of the upper urinary tract.

The aim of this study was to evaluate the feasibility and diagnostic potential of dynamic MR urography (MRU) in neonates and infants with sonographically detected abnormalities of the upper urinary tract. Thirty infants (age range 5 days to 3 years, mean age 7.9 months; male:female: 22:8) underwent MRU using T2 and contrast-enhanced dynamic T1-weighted sequences. The results were compared with the findings of ultrasound ( n=30), intravenous urography (IVU, n=19) and/or scintigraphy ( n=25) based on the criteria suggestive of obstructive uropathy. Oral sedation was sufficient to perform MRU with diagnostic quality in 20 of 21 patients younger than 1 year; 9 older patients needed intravenous sedation. Diagnosis of the 66 renal units (58 kidneys, 29 successful examinations) included normal systems (contralateral units), duplex systems, vesico-ureteral reflux, obstructive megaureter, ureteropelvic junction obstruction and accompanying renal parenchymal disease, with complex pathology in 10 patients. Magnetic resonance urography demonstrated anatomy better than IVU, particularly the renal parenchyma, (ectopic) ureters, and poorly functioning dilated systems. Magnetic resonance urography was superior to US in showing ureteral pathology. Tiny cysts in dysplastic kidneys were better seen by US. Gadolinium-enhanced dynamic MRU allowed accurate assessment of obstruction applying IVU criteria. Here MRU matched IVU results, and most of the scintigraphic findings. Magnetic resonance urography can be performed in young infants with diagnostic quality using oral sedation. Magnetic resonance urography correctly depicts anatomy and allows assessment of the urinary tract better than US and IVU, with additional functional information. Magnetic resonance urography thus has the potential to replace IVU for many indications.

Feasibility Studies↗

PubMed2007

Computed tomography urography technique, indications and limitations.

PURPOSE OF REVIEW: The review discusses the different techniques of computed tomography urography reported in the literature and presents the author's preferred approach. RECENT FINDINGS: Multiphase computed tomography urography offers a comprehensive evaluation of the urinary tract but at the cost of a large dose of contrast medium (100-150 ml), high radiation dose and massive number of images for interpretation. Diuresis induced by frusemide (10 mg) is reported to improve the depiction of ureters in the excretory phase of the examination. The author's preferred approach is a limited computed tomography urography which includes precontrast scanning of the kidneys, followed by an excretory phase 5 min after intravenous injection of 50 ml of contrast medium and 10 mg of frusemide. This limited examination in the author's experience provides a satisfactory evaluation of the urinary tract in the majority of patients, without inflicting a high radiation dose on the patient. SUMMARY: A limited computed tomography urography examination is adequate for the majority of patients requiring excretory urography and a superior replacement of conventional intravenous urography. Information provided by a multiphase computed tomography urography examination is beneficial only in a small number of patients.

Humans↗

PubMed1990

Ultrasonography compared with intravenous urography in the investigation of adults with haematuria.

OBJECTIVE: To compare ultrasonography with intravenous urography in the investigation of adults with haematuria. DESIGN: Prospective study entailing the examination of all patients with both investigations concurrently. The investigations were performed independently on routine lists by different duty radiologists. Each was aware of the details of the request form but not of the findings of the other investigation. SETTING: Radiology department of a teaching hospital. PATIENTS: 155 Consecutive adult patients (aged 18-93) referred from general practitioners and hospital outpatient clinics with a history of haematuria. FOLLOW UP: When results of both examinations proved normal no clinical or radiological follow up was sought. All abnormal findings of either investigation were correlated with results of subsequent imaging studies or operative findings. RESULTS: 81 Patients (52%) had normal findings on urography and ultrasonography. Overall, the findings of ultrasonography concurred with those of urography in 144 cases (93%). Among the discrepant findings of the two investigations ultrasonography missed two ureteric calculi; one was in a non-dilated ureter, and in the other case ultrasonography detected the secondary ureteric dilatation. Ultrasound examination alone detected four bladder tumours not visible on urography with sizes ranging from 5 to 21 mm, representing one fifth of the 20 cystoscopically proved bladder tumours detected in the series. Ultrasonography detected all the 22 neoplastic lesions discovered in the study (20 bladder, two renal). Ultrasonography clarified the nature of renal masses evident in three urograms (simple cysts). CONCLUSIONS: Ultrasonography is a safe and accurate method of investigating the urinary tract in adults with haematuria. When combined with a single plain abdominal radiograph it proved to be superior to urography as the primary imaging study in this series. Ultrasonography should certainly be preferred to urography if cystoscopy is not planned. No urothelial tumours of the upper urinary tract were found in the series, reflecting their rarity. For those patients in whom ultrasonography and plain radiography have shown no abnormality and in whom cystoscopic appearances are normal urography would be advisable to exclude urothelial tumours of the upper urinary tract.

Adolescent↗

PubMed1989

Abdominal radiograph and renal ultrasound versus excretory urography in the evaluation of asymptomatic patients after extracorporeal shock wave lithotripsy.

A prospective study was done to compare the relative efficacy of an abdominal radiograph and renal ultrasound to excretory urography for the evaluation of asymptomatic patients 1 month after extracorporeal shock wave lithotripsy. We evaluated 101 renal units in 84 asymptomatic patients who had undergone extracorporeal shock wave lithotripsy 1 month previously with abdominal radiography, excretory urography and ultrasonography to evaluate the presence of retained stone fragments, dilatation of the collecting system and intrarenal or perirenal fluid collections or masses. The combination of abdominal radiography and ultrasonography identified retained fragments in 62 renal units, while excretory urography identified them in 54. Ultrasonography was less specific in identifying dilatation of part or all of the collecting system; proving falsely positive in 7 renal units and falsely negative in 14 compared to excretory urography. However, the case of obstruction was diagnosed correctly by both modalities. Finally, ultrasound appeared to be more specific and more sensitive in the evaluation of the presence of intrarenal or perirenal abnormalities. We conclude that a combination of abdominal radiography and ultrasonography is as good or better than excretory urography in identifying residual stone fragments and intrarenal or perirenal abnormalities. However, the finding of dilatation of all or part of the collecting system by ultrasonography is nonspecific and probably is better evaluated by excretory urography. We suggest that the routine radiological evaluation of asymptomatic patients 1 month after extracorporeal shock wave lithotripsy could be limited routinely to abdominal radiography and ultrasonography. However, when abnormalities of the collecting system are visualized on these studies excretory urography should be performed.

Adolescent↗

PubMed2001

What is left of i.v. urography?

Since its introduction into clinical practice in the early 1930s, intravenous urography (IVU) was the primary imaging technique for the investigation of urinary system disorders for many years, until the advent of digital cross-sectional-imaging techniques gradually started to undermine many of its indications. Intravenous urography has been superseded for some indications such as renovascular arterial hypertension, prostatic dysuria, renal failure, palpable abdominal masses and recurrent urinary tract infection in women. Intravenous urography has been reduced, in the sense that it is no longer a primary examination, for other clinical indications such as renal colic, renal trauma, uroseptic fever, asymptomatic haematuria, medical haematuria, obstructive uropathies and follow-up of various disorders. Intravenous urography is indicated and often mandatory in congenital anomalies of the urinary tract, prior to endourological procedures, possible fistulas, renal transplantation, tuberculosis and ureteral pathology. In conclusion, IVU is still the examination of choice where there is a need to visualize the entire urinary system and to evaluate the state of the papillae and calyces. Computed tomography urography and MR urography are the imaging modalities ready in the near future to replace IVU.

Female Urogenital Diseases↗

PubMed2003

Comparison of excretory phase, helical computed tomography with intravenous urography in patients with painless haematuria.

AIM: To compare excretory phase, helical computed tomography (CT) with intravenous (IV) urography for evaluation of the urinary tract in patients with painless haematuria. MATERIALS AND METHODS: Ninety-one out-patients had IV urography followed by helical CT limited to the urinary tract. Both IV urograms and CT images were evaluated for abnormalities of the urinary tract in a blinded, prospective manner. The clinical significance of abnormalities was scored subjectively and receiver operator characteristic curve analysis was performed. RESULTS: In 69 of 91 patients (76%), no cause of haematuria was identified. In 22 of 91 patients (24%), the cause of haematuria was identified as follows: transitional cell cancer of the bladder (n=15), urinary tract stones (n=3), cystitis (n=2), haemorrhagic pyelitis (n=1) and benign ureteral stricture (n=1). With IV urography, there were 15 true-positive, seven false-negative and three false-positive interpretations. With CT, there were 18 true-positive, four false-negative and two false-positive interpretations. There was no significant difference between IV and CT urography for the significance of the positive interpretations (n=0.47). CONCLUSION: Excretory phase CT urography was comparable with IV urography for evaluation of the urinary tract in patients with painless haematuria. However, the study population did not include any upper tract cancers.

Adult↗

PubMed2001

Magnetic resonance urography in children: evaluation of suspected ureteral ectopia in duplex systems.

PURPOSE: We evaluate the diagnostic accuracy of magnetic resonance urography in children with suspected ectopic ureters and ureteroceles in duplex systems. MATERIALS AND METHODS: A total of 14 children 4 weeks to 8 years old with a total of 18 duplex systems underwent magnetic resonance urography using a 1.5 tesla scanner. After injection of low dose furosemide, half-Fourier rapid acquisition with relaxation enhancement images were obtained for T2-weighted static fluid magnetic resonance urography. Respiratory gated 3-dimensional gradient echo images were acquired for T1-weighted excretory magnetic resonance urography 5 to 30 minutes after intravenously administered gadolinium. RESULTS: All magnetic resonance examinations were successfully performed without sedation. The diagnostic accuracy of T1-weighted excretory magnetic resonance urography depended on the renal function. Twelve duplex systems with a normal excretory function, including 6 bifid ureters and 6 upper moieties with inferomedial ectopic ureters, were analyzed correctly with the exception of a 6 mm. ureterocele in 1 case. In 6 duplex systems with poor or nonfunctioning upper moieties ectopic ureters were only demonstrated on T2-weighted magnetic resonance urograms. CONCLUSIONS: Respiratory gated excretory and static fluid magnetic resonance urography complement each other in the evaluation of duplex systems in children and provide high accuracy in the evaluation of suspected ectopic ureters and ureteroceles.

Child↗

PubMed2001

[Gd-BOPTA enhanced excretory MR urography without administration of diuretics].

PURPOSE: To evaluate the feasibility and clinical utility of Gd-BOPTA enhanced excretory magnetic resonance urography without additional administration of diuretics in correlation with conventional urography. METHOD: 15 preoperative patients with pelvic tumors were examined at 1.5 T using a breath-hold high-resolution 3D-FLASH sequence during first-pass as well as 5, 10, 15 minutes after i.v. injection of 0.05 mmol/kg BW Gd-BOPTA (MultiHance) without administration of diuretics. Post-processed coronal and multiplanar MIP reconstructions were compared to conventional excretory urography with regard to morphologic accuracy, anatomic variability, filling defects, cause and level of obstruction or compression, tumor visibility, and time-effectiveness by two independent radiologists. RESULTS: Visualization of the urinary tract by MRU was comparable to conventional excretory urography in 14 of 15 cases. Caliceal fornices were better delineated on conventional urographies, whereas MRU was considered superior in the assessment of the inferior ureter sections, the urinary bladder and obstructive tumors, whose extents could be clearly marked out. Examination times of both techniques were comparable. CONCLUSION: These first results show that non-diuretic Gd-BOPTA enhanced MRU is comparable to conventional excretory urography for the preoperative diagnosis of pelvic tumors. Further improvements of this technique seem possible by optimization of examination intervals and injection doses.

Adult↗

PubMed1978

Urography in children: when should it be done? 2. Conditions other than infection.

Conditions that are often associated with an increased incidence of renal anomalies include imperforate anus, congenital vertebral abnormalities, and Fanconi anemia; excretory urography should be done if such a condition is present. Urography is also useful to provide baseline data in conditions associated with later development of urinary problems, such as myelodysplasia, prune-belly syndrome, and exstrophy of the bladder. In addition, urography serves as a periodic check for complications of treatment (hydronephrosis, obstruction) in patients with urinary diversion. Certain signs, eg, dribbling, hematuria after mild trauma, unexplained pneumothorax or pneumomediastinum in a neonate, and neonatal abdominal mass, call for immediate urography. In many conditions that were formerly thought to be associated with major urinary abnormalities, urography is not called for. Such is the case in hypospadias, deformities of the external ear alone, and undescended testes. Dehydration is the only absolute contraindication to urography.

Child↗

PubMed1998

Evaluation of DMSA scintigraphy and urography in assessing both acute and permanent renal damage in children.

PURPOSE: To evaluate dimercaptosuccinic acid (DMSA) scintigraphy and urography in the detection of renal involvement in children with urinary tract infection (UTI) in order to identify patients with a high risk of developing renal damage. MATERIAL AND METHODS: A total of 157 children (median age 0.4 years, range 5 days to 5.8 years) with first-time symptomatic UTI were examined scintigraphy (with an assessment of renal area involvement) and urography at the time of UTI and 1 year later. All evaluations were made blindly. RESULTS: Of the total 314 kidneys, 80 (25%) were abnormal at initial scintigraphy. Of these 80 kidneys, 44 (55%) had normalized at follow-up. Of the 234 initially normal kidneys, 29 (12%) were abnormal at follow-up. One year after UTI, abnormalities were seen in 59 children at scintigraphy and in 18 children at urography. Renal area involvement was larger and split function abnormalities more common in kidneys that were abnormal at both scintigraphy and urography than in kidneys with only scintigraphic abnormalities. CONCLUSION: Quantitation of renal area involvement and split renal function at early scintigraphy would seem to be useful in identifying patients at risk of developing renal damage. Urography at 1 year after infection identified mainly those with the most severe scintigraphic abnormalities. The clinical importance of scintigraphic abnormalities that are not confirmed by urography is not known.

Acute Disease↗

PubMed1990

Ultrasonography compared with intravenous urography in investigation of urinary tract infection in adults.

OBJECTIVE: To compare ultrasonography with intravenous urography for investigating adults with proved urinary tract infection. DESIGN: Prospective study of patients presenting consecutively for radiological investigation of urinary tract infection between October 1988 and December 1989. Both investigations were performed concurrently and performed independently on routine lists by different duty radiologists, each of whom knew the details on the request form but not the findings of the other investigation. SETTING: Radiology department of a teaching hospital. PATIENTS: 158 Consecutive adults (89 women, 69 men; mean age 49.7 (range 18-83)) referred from general practitioners and hospital outpatient clinics with a history of proved urinary tract infection. INTERVENTIONS: Urography and ultrasonography performed concurrently. When both examinations gave normal findings no clinical or radiological follow up was sought. All abnormal findings detected with either investigation were confirmed by subsequent imaging studies or by operative procedures. MAIN OUTCOME MEASURE: Accuracy of detection of abnormalities of urinary system by ultrasonography compared with urography. RESULTS: 113 Patients (72%) had normal urographic and ultrasonic findings. Overall, ultrasonography concurred with the findings of urography in 149 (94%) patients, and when a single abdominal radiograph was included in the procedure, in 152 (96%). Ultrasonography missed only one important diagnosis, that of mild papillary necrosis in normal sized kidneys in a diabetic patient. It detected one early bladder tumour not visible on urography and was able to clarify the nature of renal masses (simple cysts) evident on three urograms. CONCLUSION: Ultrasonography provides a safe and accurate method of imaging the urinary tract in adults with infection. Combined with a plain abdominal radiograph, it should replace urography as the initial imaging investigation in these patients. Major savings would result from adopting this policy, and the risks to patients from ionising radiation and intravenous contrast media would be appreciably reduced.

Adolescent↗

PubMed2002

Ultrasonography and abdominal radiography versus intravenous urography in investigation of urinary tract infection in men: prospective incident cohort study.

OBJECTIVES: To compare ultrasonography and abdominal radiography with intravenous urography in the investigation of urinary tract infection in men. DESIGN: Prospective study in two hospital departments. Radiological procedures and urological assessments performed on different days by different clinicians SETTING: District general hospital. PARTICIPANTS: Consecutive series of men (n=114) referred to the department of urology for investigation of proved urinary tract infection. INTERVENTIONS: Ultrasonography and intravenous urography of renal tract and assessment of urinary flow rate. Clinical assessment, cystoscopy, urodynamic studies, and transrectal ultrasonography with biopsy. MAIN OUTCOME MEASURES: Sensitivity and specificity of ultrasonography and abdominal radiography compared with intravenous urography. RESULTS: Important abnormalities were seen in 53 of 100 fully evaluated patients, the most common being a poorly emptying bladder (34). The combination of plain radiographs of kidneys, ureter, and bladder and ultrasonography detected more abnormalities than intravenous urography alone. No important abnormality was missed by this combination (sensitivity 100% and specificity 93%). CONCLUSIONS: Ultrasonography with abdominal radiography is as accurate as intravenous urography in detecting important urological abnormalities in men presenting with urinary tract infection. This combination is safer than intravenous urography and should be the initial investigation for such patients. Additional determination of urinary flow rate is useful for the assessment of an incompletely emptying bladder.

Adolescent↗

PubMed2002

Multi-detector row CT urography: comparison of strategies for depicting the normal urinary collecting system.

PURPOSE: To evaluate several protocols for depiction of the urinary collecting system with multi-detector row computed tomographic (CT) urography. MATERIALS AND METHODS: Fifty-one patients with hematuria or a suspicious renal mass underwent CT urography, during which thinly collimated (1-mm) pyelographic phase scanning was performed 8-10 minutes after contrast medium administration. Patients were examined while prone only (n = 17) and while both prone and supine (n = 17) after a 250-mL infusion of normal saline. Each collecting system and ureter was divided into six segments that were assigned opacification scores. All acquisition techniques were compared, and the highest-scoring technique was compared with that in 17 patients who underwent conventional intravenous urography (IVU). Three reconstruction techniques (transverse, coronal, and maximal intensity projection) were also compared. Stratified analysis was performed with the paired two-tailed Student t test to compare opacification scores for both the acquisition techniques and display methods, both individually and in all possible combinations. RESULTS: CT urography with supplemental saline administration, performed with the patient prone or supine, significantly improved mean opacification scores in the distal ureters (right, P =.004; left, P =.006). With this technique, CT urography produced a mean opacification score that was not significantly different from that with IVU in 11 of 12 segments and was significantly better than that with IVU in one of 12 segments (lower left ureter). Mean opacification scores obtained with transverse or coronal displays were equal to or higher than those obtained with maximum intensity projection reconstructions in all segments. CONCLUSION: CT urography with a multi-detector row scanner and supplemental infusion of normal saline reliably displays the opacified urinary collecting system.

Female↗

PubMed1995

MR urography: technique and application.

PURPOSE: To evaluate a magnetic resonance (MR) technique for depicting the kidneys and urinary tract. MATERIALS AND METHODS: Fourteen patients with urinary tract obstruction and 20 without obstructions were examined with a modified, heavily T2-weighted fast spin-echo pulse sequence (MR urography). In addition, six healthy volunteers underwent modified MR urography with intravenous administration of furosemide and ureteral compression prior to imaging. RESULTS: MR urography provided high-resolution images of the kidneys and urinary tract in all patients with obstruction with intact collecting systems. Anatomic anomalies were depicted in two patients. Intraluminal neoplasia was well demonstrated in both obstructed and nonobstructed systems (n = 4). Furosemide-enhanced MR urography provided fine anatomic and functional detail of both the kidneys and urinary tract (n = 6). CONCLUSION: MR urography may provide an alternative to more conventional urinary tract imaging techniques. It does not require ionizing radiation or iodinated contrast material. When combined with furosemide and ureteral compression, MR urography provides fine detail and reflects function.

Adult↗

PubMed1999

Radiologic investigation of renal colic: unenhanced helical CT compared with excretory urography.

OBJECTIVE: Our aim was to compare unenhanced helical CT and excretory urography in the assessment of patients with renal colic. SUBJECTS AND METHODS: Fifty-three of 70 consecutive patients with acute signs of renal colic were prospectively examined with unenhanced helical CT, which was followed immediately by excretory urography. Two radiologists who were unaware of the findings independently interpreted these examinations to determine the presence or absence of ureteral obstruction. On all CT scans that had positive findings for ureteral stones or obstruction, we looked for secondary signs of obstruction (perinephric or periureteral fat stranding, ureteral wall edema, ureteral dilatation, and blurring of renal sinus fat). RESULTS: A stone was recovered in 45 of the 53 patients, nine before and 36 after imaging. The latter 36 patients had their stones identified on CT, whereas only 24 patients had their stones identified on excretory urography. Eight patients without stone disease had normal ureters on both CT and excretory urography. Of the 45 patients who had stone disease, 26 had ureteral dilatation on both CT and excretory urography, and 36 patients who recovered a stone after CT had secondary signs of obstruction. Of the nine patients who recovered a stone before CT, three had secondary signs of obstruction. Two patients had periureteral fat stranding, ureteral wall edema, and renal sinus fat blurring. One patient had only ureteral wall edema. CONCLUSION: Compared with excretory urography, unenhanced helical CT is better for identifying ureteral stones in patients with acute ureterolithiasis. Secondary CT signs of obstruction, including renal sinus fat blurring, were frequently present even when the stone was eliminated before imaging.

Acute Disease↗

PubMed2005

MDCT urography of upper tract urothelial neoplasms.

OBJECTIVE: The purpose of our study was to review the MDCT urography appearance of pathologically proven transitional cell carcinomas of the renal collecting system and ureter and to correlate the MDCT urography findings with pathology findings. MATERIALS AND METHODS: Of 370 MDCT urography examinations performed over an 18-month period, 18 patients were diagnosed with 27 renal collecting system or ureteral urothelial neoplasms at endoscopic biopsy (n = 8) or surgery (n = 19). Initial MDCT reports were reviewed to determine the sensitivity of original reviewers in detecting these neoplasms. Two radiologists also retrospectively reviewed these scans and characterized the CT appearance of the neoplasms on both axial CT and 3D reformatted images. Findings at retrospective review were correlated with pathology results to determine whether any CT features could be used to predict tumor grade. RESULTS: Eighteen of 27 neoplasms were prospectively identified on MDCT urography, and an additional six neoplasms were detected on retrospective review. Three ureteral neoplasms could not be visualized. The 24 retrospectively detected neoplasms had three distinct MDCT appearances: circumferential urothelial wall thickening (n = 14), small masses (> 5 mm in maximal diameter) (n = 5), and large masses (> 5 mm in maximal diameter) (n = 5). All detected lesions could be seen on axial excretory phase images provided wide window settings were reviewed; however, only six were detected on 3D reconstructions. MDCT urography appearance did not correlate with tumor grade. CONCLUSION: MDCT urography is a promising technique for detecting upper urinary tract neoplasms. The static 3D reconstructions used in this study are insufficient for visualization. Axial image review remains essential for tumor identification.

Aged↗

PubMed2000

Nonnephrotoxic, dynamic, contrast enhanced magnetic resonance urography: use in nephrology and urology.

PURPOSE: We assessed the value of breath-hold, gadolinium (Gd) enhanced magnetic resonance urography for diagnosing urinary tract disease. MATERIALS AND METHODS: Dynamic magnetic resonance urography was performed in 38 consecutive patients presenting with urological disease in whom excretory urography was contraindicated. Renal function was impaired in 18 cases with a serum creatinine of 140 to 400 micromol./l. Fast spoiled, gradient echo sequences were acquired during breath-holding 5, 10 and 15 minutes after intravenous injection of 10 ml. of a Gd chelate. Opacification of the collecting system was evaluated using a scale of 0 to 3. Diagnostic value of the examinations was also analyzed. RESULTS: Dynamic magnetic resonance urography was sufficient for making the diagnosis in 95% of cases. We identified 71 pathological findings and the surgical anastomosis was always well visualized. Mean image quality score was 2.34 points for renal calices, 2.86 for renal pelves and 2.48 for ureters. Image quality significantly improved after injecting a diuretic. CONCLUSIONS: Gd enhanced magnetic resonance urography provides quality dynamic imaging of the urinary tract. It is a new approach for diagnosing urinary tract disorders in patients in whom excretory urography should be avoided.

Adult↗