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Objective To assess the value of functional magnetic resonance urography (fMRU)for the unilateral renal function in children with hydronephrosis.Methods Fourteen children with congenital hydronephrosis (unilateral hydronephrosis in 1 2 cases,bilateral hydronephrosis in 2 cases)examined by fMRU in Beijing Children′s Hospital,Capital Medical University,were enrolled.In 7 patients of them,diuretic renal scintigraphy (DRS)was per-formed within 1 0 days before fMRU examination.The following parameters in fMRU,as renal parenchymal volume,volu-metric differential renal function (vDRF),Patlak,Patlak differential renal function (pDRF),index of glomerular filtra-tion rate (GFR)and differential renal function based on index of GFR (gDRF),were calculated and analyzed.Statisti-cal analysis was performed by using SPSS 1 3.0.Results In 7 cases whose fMRU and DRS were examined,the indexes of GFR obtained from fMRU and GFR from DRS were well correlated (r =0.892,P <0.001 )in 1 4 kidneys.The gDRF determined by 2 methods on the left kidneys[the average was(46.80 ±1 9.20)% and(45.1 8 ±20.29)%,respective-ly]had no significant difference (t =0.051 6,P =0.624),which was also highly correlated (r =0.91 2,P =0.004). In 1 2 cases with unilateral hydronephrosis,vDRF,pDRF,index of GFR and gDRF in hydronephrotic side[(43.54 ± 9.61 )%,(42.80 ±1 0.83)%,(38.56 ±29.23)mL/min,(38.37 ±1 3.61 )%]were all less than those in the con-tralateral side[(56.46 ±9.61 )%,(57.1 9 ±1 0.83)%,(57.02 ±26.22)mL/min,(61 .63 ±1 3.61 )%](t =2.326, 2.300,2.422,2.960;P =0.040,0.042,0.034,0.01 3).However,there was no statistical difference in both renal pa-renchymal volume and Patlak between the hydronephrotic and the contralateral side kidneys(t =1 .765,1 .450;P =0.1 05,0.1 75).Conclusions fMRU is a very valuable examination method in evaluating single kidney function in children with congenital hydronephrosis,and able to demonstrate that gDRF,indexes of GFR,vDRF and pDRF decrease in the hydronephrotic kidney.
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Objective To establish a dual contrast-enhanced ultrasonography (DCEUS) method for diagnosing the upper urinary tract obstructive diseases, and to discuss the diagnosis criterion and value. Methods A total of 147 patients with upper urinary tract obstructive diseases underwent dual contrast-enhanced ultrasound examination. A dose of SonoVue solution was directly injected into the renal pelvis via the puncture tube, and the antegrade contrast agent movement within the upper urinary tract was continuously monitored under CPS mode. Meanwhile, intravenous contrast-enhanced ultrasound was performed to observe the capillary filling of the urinary tract and surrounding structures, that is what we called DCEUS. And all the patient received magnetic resonance urography (MRU) and urinary contrast-enhanced CT within one week. With the operative findings and/or postoperative pathology taken as the golden standard, the accuracies of DCEUS and MRU in diagnosing the obstructive levels and severity of upper urinary tract obstruction were compared, and the accuracies of DCEUS and contrast-enhanced CT in diagnosing causes of the obstruction were compared. Results (1)The accuracy of DCEUS in revealing the obstructive levels were 100%, showing no significant difference with MRU(98. 6%)(P>0. 05). (2)The accuracy of DCEUS in evaluating the severity of upper urinary tract obstruction was 98. 6%, which was significantly better than that of MRU(89. 8%, P0. 05). (4) No complications were found during renal pelvis puncture or administration of SonoVue in the 147 patients,and no late complications were noticed during 1-6 months ultrasound follow-up in the 143 patients whowere followed up. Conclusion DCEUS is a safe, effective method; it can accurately locate the upper urinary tract obstruction and help to make qualitative diagnosis, and combination with percutaneous nephrostomy can yield even better clinical values.
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Objective To discuss the inspect technique and methods of magnetic resonance urography(MRU)in pediatric urinary system. Methods 16 cases with urinary system diseases were analyzed retrospectively,including axial routine FRFSE T2WI with fat saturation and three-dimensional MRU. The three-dimensional(3D) imaging data were sent to AW4.2 workstation,then edited and reconstructed with maximum intensity projection(MIP) and rebuilt. Results 12 cases in 16 cases were congenital abnormality by MRU diagnosis,3 cases were Urinary system diseases and 1 case was normal. 10 cases in 16 cases were performed with surgical intervention,6 cases with medical treatment,which clinical diagnosis were consistent with MRU. 16 cases were accepted examination with B -ultrasonic,6 cases CT and 9 cases IVP. Diagnose accordance rates with MRU were B-ultrasonic 93.7%(15/16),CT 66.7%(4/6),IVP 66.7%(6/9).Conclusion MRU is a safe,convincible and convenient technique,which can provide high quality imaging,so it will be a kind of non-injury imaging method in diagnosing the diseases of pediatric urinary system diseases.
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Objective:To explore the clinical application in urinary system stones of the inspection technologies intravenous pyelography (IVP),computer tomography urography (CTU) and magnetic resonance urography (MRU). Methods:We collected 100 cases of urinary system stones on which 80 were carried out to IVP,60 to CTU and 35 to MRU,25 patients were implemented all 3 examinations. CTU and MRU are reconstructed with multi-level reorganization (MPR),curved projection reproduction (CPR),volume reproduction (VR) and the maximum intensity projection (MIP). Results:Stones were found in 73 patients of the 80 people by IVP,the diagnosis rate is 91.3 %. Stones were found in all the 60 patients except 1 by CTU with images direct and accurate,the diagnosis rate was 98.1 %. By the MRU,stones were found in 20 of the 35 patients at a display rate of 57.1 %,with images displayed in a low stone location signal,filling defect and the hydrocele circs of renal pelvis and ureter. Conclusion:IVP is a simple method,easy-to-patient acceptance and has a high detection rate of stones; CTU has a good image quality and the detection rate is higher than the stone IVP. By combining with the original cross-sectional image,the rate of diagnosis is up to 98%; as a non-invasive and no contrast agent approach,MRU is also very important in the diagnosis of stones.
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Objective To explore the clinical application and significance of Magnetic Resonance Urography.Methods T1WI and T2WI images in transverse section and T1WI images in coronary section were obtained.Then fast spiral echo sequence was used to get weighted T2WI images and the images were reconstructed with MIP(maximum intensity projection).Results Among the 20 cases,18 MRU images met the diagnostic need,and 2 cases failed because of poor preparation.Conclusion MRU is suitable for the patients who are inappropriate to do IVP(intravenous pyelography),such as urinary tract restricted and obstructed,old people,poor physical condition and iodine allergy,or the patients who did IVP but there were no contrast agent discerned.
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Objective To evaluate the diagnostic value of magnetic resonance urography(MRU)in patients with iatrogenic ureteral injuries.Methods MRU in 12 patients with iatrogenic ureteral injuries caused by gynecological and rectal operation were performed.Results MRU examinations were successfully done in all cases at once.The accurate rate in localized and qualitative diagnosis was all 100%.The injures of ureter in 12 cases were all located at lower segment of the ureter,of them,8 patients were purely obstruction,4 cases were obstruction with urinal leakage,all cases were accompanied by dilations of ureter and hydronephrosis.Conclusion MRU is helpful for the diagnosis of iatrogenic ureteral injury.
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Objective To evaluate the diagnostic value of MR urography(MRU) in the diagnosis of renal tuberculosis. Methods MRU features of 18 cases of renal tuberculosis,nonvisualized or poorly visualized in IVU,were analyzed and compared with pathologic findings. Results MRU provided high-resolution images of the kidneys and upper urinary tract in all patients.MRU features of renal tuberculosis and corresponding pathologic changes were summarized. Conclusions MRU has a great value in diagnosing renal tuberculosis when the kidneys are nonvisualized or poorly visualized in IVU.It can provide diagnostic evidence and is helpful with choice of the therapeutic strategy.