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Magnetic Resonance Voiding Cystography in the Diagnosis of Vesicoureteral Reflux: Comparative Study With Voiding Cystourethrography

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Author(s)
이상권김영환우성구
Alternative Author(s)
Lee, Sang KwonKim, Young HwanWoo, Seong Ku
Publication Year
2005
Keyword
voiding cystourethrographyureterrefluxkidneymagnetic resonance (MR)comparative studies
Abstract
Purpose: To evaluate the feasibility of magnetic resonance
voiding cystography (MRVC) compared with voiding cystourethrography
(VCUG) for detecting and grading vesicoureteral
reflux (VUR).
Materials and Methods: MRVC was performed upon 20
children referred for investigation of reflux. Either coronal
T1-weighted spin-echo (SE) or gradient-echo (GE) (fast multiplanar
spoiled gradient-echo (FMPSPGR) or turbo fast lowangle-
shot (FLASH)) images were obtained before and after
transurethral administration of gadolinium solution, and immediately
after voiding. The findings of MRVC were compared
with those of VCUG and technetium-99m (99mTc) dimercaptosuccinic
acid (DMSA) single-photon emission computed tomography
(SPECT) performed within 6 months of MRVC.
Results: VUR was detected in 23 ureterorenal units (16
VURs by both methods, 5 VURs by VCUG, and 2 VURs by
MRVC). With VCUG as the standard of reference, the sensitivity
of MRVC was 76.2%; the specificity, 90.0%; the
positive predictive value, 88.9%; and the negative predictive
value, 78.3%. There was concordance between two methods
regarding the grade of reflux in all 16 ureterorenal units
with VUR detected by both methods. Of 40 kidneys, MRVC
detected findings of renal damage or reflux nephropathy in
13 kidneys, and 99mTc DMSA renal SPECT detected findings
of reflux nephropathy in 17 kidneys.
Conclusion: Although MRVC is shown to have less sensitivity
for VUR than VCUG, MRVC may represent a method
of choice offering a safer nonradiation test that can additionally
evaluate the kidneys for changes related to reflux
nephropathy.
Department
Dept. of Radiology (영상의학)
Publisher
School of Medicine
Citation
Journal of Magnetic Resonance Imaging, Vol.21(4) : 406-414, 2005
Type
Article
ISSN
1053-1807
DOI
10.1002/jmri.20273
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34157
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