Feasibility of MR urography in patients with urinary diversion

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Abstract

Introduction:

The aims of this study were to determine the diagnostic value of MR urography and to compare the T2- and T1-weighted MR urography techniques in patients with urinary diversion.

Methods:

We retrospectively reviewed 19 MR urograms in 14 patients (13 male and one female, 8–77 years old, mean age: 54.2) with urinary diversion. Magnetic resonance urography examinations were performed with 1.5-T MR scanners. In addition to T2- and T1-weighted MR urography techniques, conventional T1- and T2-weighted axial and coronal sequences were also obtained. Collecting systems were evaluated in five segments (right proximal and distal collecting system, left proximal and distal collecting system and conduit or reservoir). Imaging features of the urinary collecting systems were evaluated with T2- and T1-weighted MR urography images. The clinical, laboratory data and follow-up imaging findings were regarded as standard. A cross table was formed to determine sensitivity, specificity and accuracy of MR urography techniques.

Results:

T2-weighted MR urography, T1-weighted MR urography and combination of these two techniques could demonstrate 89.01, 87.65 and 93.83% of all collecting system segments, respectively. For the detection of the pathologic urinary segments, sensitivity, specificity and accuracy were 100, 95.29 and 95.6% in T2-weighted MR urography and 100, 93.42 and 93.82% in T1-weighted MR urography, respectively. Sensitivity, specificity and accuracy were 100% in combined T2- and T1-weighted MR urography technique.

Conclusion:

Magnetic resonance urography is an effective imaging method for the evaluation of the urinary system in patients with urinary diversion. T2-weighted MR urography alone has high sensitivity, specificity and accuracy, does not require intravenous contrast medium and can be obtained in 3–5 min. However, T1-weighted MR urography may provide additional information in some cases.

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