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Imaging of the urinary tract: the role of CT and MRI.

Hiorns MP - Pediatr. Nephrol. (2010)

Bottom Line: Computed tomography (CT) and magnetic resonance imaging (MRI) are increasingly valuable tools for assessing the urinary tract in adults and children.The use of CT and MRI should therefore be tailored to the patient and the clinical question.For the scope of this article, the advantages and disadvantages of these techniques in children will be considered; different considerations will apply in adult practice.

View Article: PubMed Central - PubMed

Affiliation: Great Ormond Street Hospital for Children - Radiology Department, Great Ormond Street, London, WC1N 3JH, UK. hiornm@gosh.nhs.uk

ABSTRACT
Computed tomography (CT) and magnetic resonance imaging (MRI) are increasingly valuable tools for assessing the urinary tract in adults and children. However, their imaging capabilities, while overlapping in some respects, should be considered as complementary, as each technique offers specific advantages and disadvantages both in actual inherent qualities of the technique and in specific patients and with a specific diagnostic question. The use of CT and MRI should therefore be tailored to the patient and the clinical question. For the scope of this article, the advantages and disadvantages of these techniques in children will be considered; different considerations will apply in adult practice.

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Related in: MedlinePlus

Magnetic resonance image: coronal T2 sequence in a 6-month-old girl with autosomal dominant polycystic kidney disease showing multiples high-signal cysts throughout both kidneys
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Fig1: Magnetic resonance image: coronal T2 sequence in a 6-month-old girl with autosomal dominant polycystic kidney disease showing multiples high-signal cysts throughout both kidneys

Mentions: In pediatric practice, many congenital conditions of the urinary tract are demonstrated in utero on antenatal scans, whereas some are only detected in infancy or later due to subsequent complications. Ninety percent of fetal kidneys can be identified by 17–20 weeks of gestation and 95% by 22 weeks. Both antenatally and postnatally, US remains the examination of choice in demonstrating kidney and urinary tract anatomy. Structural urinary tract anomalies include renal dysplasia, renal hypoplasia, renal aplasia, multicystic dysplastic kidney, pelviureteric junction obstruction, duplication anomalies, fusion anomalies, renal ectopia, ureteroceles, cystic kidney diseases, and posterior urethral valves. All of these may be demonstrated by US, with additional information being acquired in some cases by other modalities (such as nuclear medicine imaging or fluoroscopy). MRI may subsequently be useful in these patients, as illustrated in Fig. 1 for cystic disease, either in the further workup following US [7, 9] when the clinical question has not been resolved, or when the child presents with (or has) complications that remain unexplained by US or require further delineation [10–12]. Heavily T2-weighted sequences (water-based sequences) are very useful in demonstrating dilatation of the urinary tract secondary to congenital anomalies, such as duplex kidneys with dilated moieties and occult moieties in a previously undiagnosed duplex kidney [13] (Fig. 2), and for demonstrating the exact anatomy of fusion anomalies, such as a crossed, fused, ectopic kidney and horseshoe kidney [4, 6].Fig. 1


Imaging of the urinary tract: the role of CT and MRI.

Hiorns MP - Pediatr. Nephrol. (2010)

Magnetic resonance image: coronal T2 sequence in a 6-month-old girl with autosomal dominant polycystic kidney disease showing multiples high-signal cysts throughout both kidneys
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2991216&req=5

Fig1: Magnetic resonance image: coronal T2 sequence in a 6-month-old girl with autosomal dominant polycystic kidney disease showing multiples high-signal cysts throughout both kidneys
Mentions: In pediatric practice, many congenital conditions of the urinary tract are demonstrated in utero on antenatal scans, whereas some are only detected in infancy or later due to subsequent complications. Ninety percent of fetal kidneys can be identified by 17–20 weeks of gestation and 95% by 22 weeks. Both antenatally and postnatally, US remains the examination of choice in demonstrating kidney and urinary tract anatomy. Structural urinary tract anomalies include renal dysplasia, renal hypoplasia, renal aplasia, multicystic dysplastic kidney, pelviureteric junction obstruction, duplication anomalies, fusion anomalies, renal ectopia, ureteroceles, cystic kidney diseases, and posterior urethral valves. All of these may be demonstrated by US, with additional information being acquired in some cases by other modalities (such as nuclear medicine imaging or fluoroscopy). MRI may subsequently be useful in these patients, as illustrated in Fig. 1 for cystic disease, either in the further workup following US [7, 9] when the clinical question has not been resolved, or when the child presents with (or has) complications that remain unexplained by US or require further delineation [10–12]. Heavily T2-weighted sequences (water-based sequences) are very useful in demonstrating dilatation of the urinary tract secondary to congenital anomalies, such as duplex kidneys with dilated moieties and occult moieties in a previously undiagnosed duplex kidney [13] (Fig. 2), and for demonstrating the exact anatomy of fusion anomalies, such as a crossed, fused, ectopic kidney and horseshoe kidney [4, 6].Fig. 1

Bottom Line: Computed tomography (CT) and magnetic resonance imaging (MRI) are increasingly valuable tools for assessing the urinary tract in adults and children.The use of CT and MRI should therefore be tailored to the patient and the clinical question.For the scope of this article, the advantages and disadvantages of these techniques in children will be considered; different considerations will apply in adult practice.

View Article: PubMed Central - PubMed

Affiliation: Great Ormond Street Hospital for Children - Radiology Department, Great Ormond Street, London, WC1N 3JH, UK. hiornm@gosh.nhs.uk

ABSTRACT
Computed tomography (CT) and magnetic resonance imaging (MRI) are increasingly valuable tools for assessing the urinary tract in adults and children. However, their imaging capabilities, while overlapping in some respects, should be considered as complementary, as each technique offers specific advantages and disadvantages both in actual inherent qualities of the technique and in specific patients and with a specific diagnostic question. The use of CT and MRI should therefore be tailored to the patient and the clinical question. For the scope of this article, the advantages and disadvantages of these techniques in children will be considered; different considerations will apply in adult practice.

Show MeSH
Related in: MedlinePlus