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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

Computed tomography: Reconstructed 3D images showing the complicated anatomy of the urogenital tract in a 3-month-old girl with a cloacal anomaly; the entire urogenital system is demonstrated in one study
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Fig5: Computed tomography: Reconstructed 3D images showing the complicated anatomy of the urogenital tract in a 3-month-old girl with a cloacal anomaly; the entire urogenital system is demonstrated in one study

Mentions: Very complex urogenital anomalies, such as cloacal anomalies in female patients, are usually imaged by US and fluoroscopy in the first instance, but further cross-sectional imaging is invariably required. MRI may offer satisfactory depiction of the anatomy, but frequently, the workup has to occur very soon after birth so that an intermediate management plan can be made before definite surgery can be performed when the infant is older. In this situation, MRI is rarely able to offer sufficient spatial resolution to allow full understanding of the anatomy in these very small patients. In a few very select cases, CT, with a combined distal loopogram and micturating cystogram performed at the time of the scan, as well as contrast intravenously with the scan delayed to excretory phase, can offer exceptional 3D visualization of the entire urogenital tract (Fig. 5). There is little value in a conventional CT alone in these cases, and the routine use of CT is absolutely not advocated.Fig. 5


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

Hiorns MP - Pediatr. Nephrol. (2010)

Computed tomography: Reconstructed 3D images showing the complicated anatomy of the urogenital tract in a 3-month-old girl with a cloacal anomaly; the entire urogenital system is demonstrated in one study
© Copyright Policy
Related In: Results  -  Collection

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

Fig5: Computed tomography: Reconstructed 3D images showing the complicated anatomy of the urogenital tract in a 3-month-old girl with a cloacal anomaly; the entire urogenital system is demonstrated in one study
Mentions: Very complex urogenital anomalies, such as cloacal anomalies in female patients, are usually imaged by US and fluoroscopy in the first instance, but further cross-sectional imaging is invariably required. MRI may offer satisfactory depiction of the anatomy, but frequently, the workup has to occur very soon after birth so that an intermediate management plan can be made before definite surgery can be performed when the infant is older. In this situation, MRI is rarely able to offer sufficient spatial resolution to allow full understanding of the anatomy in these very small patients. In a few very select cases, CT, with a combined distal loopogram and micturating cystogram performed at the time of the scan, as well as contrast intravenously with the scan delayed to excretory phase, can offer exceptional 3D visualization of the entire urogenital tract (Fig. 5). There is little value in a conventional CT alone in these cases, and the routine use of CT is absolutely not advocated.Fig. 5

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