Agreement between static magnetic resonance urography and diuretic renal scintigraphy in patients with ureteropelvic junction obstruction after pyeloplasty

Mazdak, Hamid; Karam, Mehdi; Ghassami, Fatemeh; Malekpour, Alireza

Agreement between static magnetic resonance urography and diuretic renal scintigraphy in patients with ureteropelvic junction obstruction after pyeloplasty

Authors

¹ Departments of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

² Department of Radiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

³ Department of Radiology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: Ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis within childhood that usually treat by surgery. According to anatomical variations in different individuals, scheduling similar procedures for all patients is not suitable, and thus the best decision for an appropriate surgical technique should be considered separately for each patient. Regardless of the type of applied technique, creating a funnel-shape UPJ with a suitable size is a successful treatment. In this context, the assessment of a successful surgical treatment in a short-term follow-up means repairing revealed anatomical defects. The present study aimed to compare the diagnostic value of static magnetic resonance urography (MRU) and diuretic-based renalscintigraphy (DRS) in patients with UPJO after pyeloplasty.
Materials and Methods: A total of 30 consecutive patients with UPJO, who underwent unilateral pyeloplasty between 2012 and 2013 were assessed. All subjects underwent DRS and also MRU about 1-month after the former procedure.
Results: The Kendall's tau correlation showed a very strong correlation between results of MRU and diuretic renal scintigraphy (r = 0.932, P < 0.001). This strong correlation was also shown by Somers'd test (r = 0.932, P < 0.001) similarly.
Conclusions: Our study shows a strong agreement between DRS and MRU to assess UPJO. MRU static fluid has a high accuracy for assessment of renal system anatomy. Due to the lack of dangerous consequences of contrast materials, MRU can be the best option instead of DRS.

Keywords

References

1.	McDaniel BB, Jones RA, Scherz H, Kirsch AJ, Little SB, Grattan-Smith JD. Dynamic contrast-enhanced MR urography in the evaluation of pediatric hydronephrosis: Part 2, anatomic and functional assessment of ureteropelvic junction obstruction [corrected]. AJR Am J Roentgenol 2005;185:1608-14.
2.	Lawler LP, Jarret TW, Corl FM, Fishman EK. Adult ureteropelvic junction obstruction: Insights with three-dimensional multi-detector row CT. Radiographics 2005;25:121-34.
3.	Kausik S, Segura JW. Surgical management of ureteropelvic junction obstruction in adults. Int Braz J Urol 2003;29:3-10.
4.	Kogan BA. Disorders of the ureter and ureteropelvic junction. In: Tanagho EA, McAninch JW, editors. Smith's General Urology. 17^th ed. New York: McGraw Hill; 2008. p. 564-8.
5.	Nakada SY, Hsu TH. Management of upper urinary tract obstruction. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh Urology. 10^th ed. Philadelphia: Elsevier Saunders; 2012. p. 1141-7.
6.	Amling CL, O'Hara SM, Wiener JS, Schaeffer CS, King LR. Renal ultrasound changes after pyeloplasty in children with ureteropelvic junction obstruction: Long-term outcome in 47 renal units. J Urol 1996;156:2020-4.
7.	Sarhan O, Helmy T, Abou-El Ghar M, Baky MA, El-Assmy A, Dawaba M. Long-term functional and morphological outcome after pyeloplasty for huge renal pelvis. BJU Int 2011;107:829-33.
8.	Kaneyama K, Yamataka A, Someya T, Itoh S, Lane GJ, Miyano T. Magnetic resonance urographic parameters for predicting the need for pyeloplasty in infants with prenatally diagnosed severe hydronephrosis. J Urol 2006;176:1781-4.
9.	Cerwinka WH, Damien Grattan-Smith J, Kirsch AJ. Magnetic resonance urography in pediatric urology. J Pediatr Urol 2008;4:74-82.
10.	Little SB, Jones RA, Grattan-Smith JD. Evaluation of UPJ obstruction before and after pyeloplasty using MR urography. Pediatr Radiol 2008;38 Suppl 1:S106-24.
11.	Borthne A, Pierre-Jerome C, Nordshus T, Reiseter T. MR urography in children: Current status and future development. Eur Radiol 2000;10:503-11.
12.	Kirsch AJ, McMann LP, Jones RA, Smith EA, Scherz HC, Grattan-Smith JD. Magnetic resonance urography for evaluating outcomes after pediatric pyeloplasty. J Urol 2006;176:1755-61.
13.	Blandino A, Gaeta M, Minutoli F, Salamone I, Magno C, Scribano E, et al.MR urography of the ureter. AJR Am J Roentgenol 2002;179:1307-14.
14.	El-Nahas AR, Abou El-Ghar ME, Refae HF, Gad HM, El-Diasty TA. Magnetic resonance imaging in the evaluation of pelvi-ureteric junction obstruction: An all-in-one approach. BJU Int 2007;99:641-5.
15.	Kocaoglu M, Ilica AT, Bulakbasi N, Ergin A, Ustünsöz B, Sanal T, et al.MR urography in pediatric uropathies with dilated urinary tracts. Diagn Interv Radiol 2005;11:225-32.
16.	Payabvash S, Kajbafzadeh AM, Saeedi P, Sadeghi Z, Elmi A, Mehdizadeh M. Application of magnetic resonance urography in diagnosis of congenital urogenital anomalies in children. Pediatr Surg Int 2008;24:979-86.
17.	Vegar-Zubovic S, Kristic S, Lincender L. Magnetic resonance urography in children – When and why? Radiol Oncol 2011;45:174-9.
18.	Kajbafzadeh AM, Payabvash S, Sadeghi Z, Elmi A, Jamal A, Hantoshzadeh Z, et al.Comparison of magnetic resonance urography with ultrasound studies in detection of fetal urogenital anomalies. J Pediatr Urol 2008;4:32-9.
19.	Cho SY, Kim IS, Lee SB, Choi H, Park K. Nature and fate of supranormal differential renal function: Lessons from long-term follow-up after pyeloplasty. Urology 2013;81:163-7.
20.	Shokeir AA, El-Diasty T, Eassa W, Mosbah A, El-Ghar MA, Mansour O, et al.Diagnosis of ureteral obstruction in patients with compromised renal function: The role of noninvasive imaging modalities. J Urol 2004;171:2303-6.

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